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Free Content Risk factors associated with default among new pulmonary TB patients and social support in six Russian regions

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Abstract:

SETTING: Tuberculosis (TB) services in six Russian regions in which social support programmes for TB patients were implemented.

OBJECTIVE: To identify risk factors for default and to evaluate possible impact of social support.

METHODS: Retrospective study of new pulmonary smear-positive and smear-negative TB patients registered during the second and third quarters of the 2003. Data were analysed in a case-control study including default patients as cases and successfully treated patients as controls, using multivariate logistic regression modelling.

RESULTS: A total of 1805 cases of pulmonary TB were enrolled. Default rates in the regions were 2.3–6.3%. On multivariate analysis, risk factors independently associated with default outcome included: unemployment (OR 4.44; 95%CI 2.23–8.86), alcohol abuse (OR 1.99; 95%CI 1.04–3.81), and homelessness (OR 3.49; 95%CI 1.25–9.77). Social support reduced the default outcome (OR 0.13; 95%CI 0.06–0.28), controlling for age, sex, region, residence and acid-fast bacilli (AFB) smear of sputum.

CONCLUSION: Unemployment, alcohol abuse and homelessness were associated with increased default outcome among new TB patients, while social support for TB patients reduced default. Further prospective randomised studies are necessary to evaluate the impact and to determine the most cost-effective social support for improving treatment outcomes of TB in patients in Russia, especially among populations at risk of default.

Keywords: social support; treatment default outcome; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Office of the Special Representative of the World Health Organization Director-General, Russia, Moscow, Russia 2: Research Institute of Phthisiopulmonology, Sechenov Moscow Medical Academy, Samara, Russia 3: Samara State Medical University, Division of TB and Lung Diseases, Samara, Russia

Publication date: 2007-01-01

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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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