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Free Content Risk factors for defaulting from anti-tuberculosis treatment under directly observed treatment in Hong Kong

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OBJECTIVE: To identify risk factors for defaulting from anti-tuberculosis treatment.

SETTING: Directly observed treatment in Hong Kong Government chest clinics.

DESIGN: Defaulters were recruited from a cohort of tuberculosis patients registered from 1 January to 31 March 1999. Three controls per case, matched for age and sex, were selected randomly from the cohort. Patient factors, initial tuberculosis characteristics and treatment-related variables were collected by review of medical records.

RESULTS: On matching 102 defaulters and 306 controls, a logistic risk model of default that considered patient factors, initial disease characteristics and treatment-related factors identified seven risk factors: current smoking (OR 3.00, 95%CI 1.41–6.39), past TB with default (OR 6.23, 95%CI 1.95–19.91), poor initial adherence (OR 117.21, 95%CI 13.52–1015.92), fair initial adherence (OR 11.02, 95%CI 2.15–56.43), unknown initial adherence (OR 6.59, 95%CI 3.47–12.49), treatment side effects (OR 13.30, 95%CI 3.23–54.79), and subsequent hospitalisation (OR 0.27, 95%CI 0.11–0.67). Its predictive power was 85%. Another model that considered only factors on registration for treatment gave a lower predictive power of 70%.

CONCLUSIONS: Treatment default could be predicted fairly accurately by considering patient and treatment-related factors.

Keywords: adherence; treatment; tuberculosis

Document Type: Regular Paper

Affiliations: TB and Chest Service, Department of Health, Hong Kong

Publication date: 2004-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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