If you are experiencing problems downloading PDF or HTML fulltext, our helpdesk recommend clearing your browser cache and trying again. If you need help in clearing your cache, please click here . Still need help? Email help@ingentaconnect.com

Free Content Predictors and mortality associated with treatment default in pulmonary tuberculosis

(PDF 270.2kb)
Download Article:


OBJECTIVE: To identify risk factors for default from pulmonary tuberculosis (TB) treatment and to assess mortality associated with default in Estonia.

DESIGN: All patients with culture-confirmed pulmonary TB who started treatment during 2003–2005 were included in a retrospective cohort study.

RESULTS: In 1107 eligible patients, the treatment success rate was 81.5% and the default rate 9.4% (respectively 60.4% and 17.0% in multidrug-resistant TB [MDR-TB]). Independent predictors of treatment default were alcohol abuse (OR 3.22, 95%CI 1.93–5.38), unemployment (OR 3.05, 95%CI 1.84–5.03), MDR-TB (OR 2.17, 95%CI 1.35–3.50), urban residence (OR 1.85, 95%CI 1.00–3.42) and previous incarceration (OR 1.78, 95%CI 1.05–3.03). Of the defaulters, 29.4% died during follow-up (median survival 342.0 days). Cox regression analysis revealed that unemployment was associated with all-cause and TB-related mortality among defaulters (respectively HR 4.58, 95%CI 1.05–20.1 and HR 11.2, 95%CI 1.58–80.2). HIV infection (HR 51.2, 95%CI 6.06–432), sputum smear positivity (HR 9.59, 95%CI 1.79–51.4), MDR-TB (HR 8.56, 95%CI 1.81–40.4) and previous TB (HR 5.15, 95%CI 1.64–16.2) were predictors of TB-related mortality.

CONCLUSION: The main risk factors for treatment default can be influenced. Interventions to reduce default should therefore concentrate on socially disadvantaged patients and prevention of alcohol abuse, with special attention given to MDR-TB patients.

Keywords: mortality; multidrug-resistant tuberculosis; pulmonary tuberculosis; treatment default

Document Type: Regular Paper

Affiliations: Department of Pulmonary Medicine, University of Tartu, Tartu, Estonia

Publication date: April 1, 2010

More about this publication?
  • 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

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • ingentaconnect is not responsible for the content or availability of external websites
Related content



Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more