Predictors of failure to complete tuberculosis treatment in London, 2003–2006
OBJECTIVES: To investigate tuberculosis (TB) treatment completion failure in London and associated risk factors during 2003–2006.
DESIGN: Cross-sectional analysis of treatment outcome and other explanatory variables in a cohort of TB patients reported to the London TB Register from 2003 to 2006.
METHODS: An innovative definition of TB treatment outcome more suitable for low-incidence industrialised countries, such as the United Kingdom, was adopted. A multivariable logistic approach was used to assess predictors of unsuccessful outcome.
RESULTS: A total of 12 929 TB cases were notified from 2003 to 2006, of which 12% (n = 1536) failed to complete TB treatment. The proportion of cases failing to complete treatment showed a significant decrease from 2003 to 2006 (13% in 2003 vs. 10% in 2006). Males, the elderly, hospitalised patients, short- and long-term immigrants, Whites and the least deprived were more likely to fail to complete treatment.
CONCLUSIONS: The proportion of TB treatment success in London exceeded the World Health Organization recommended threshold of 85%. Some specific categories of patients that are more likely to fail to complete treatment should be targeted by health services to enhance their engagement and adherence to the treatment regimen.
Document Type: Regular Paper
Affiliations: 1: London Regional Epidemiology Unit, Health Protection Agency, London, UK; Department of Environmental Medicine and Public Health, University of Padua, Padua, Italy; and Schoolof Public Health, Imperial College, London, UK 2: London Regional Epidemiology Unit, Health Protection Agency, London, UK; and St George's Hospital Medical School, London, UK 3: Department of Environmental Medicine and Public Health, University of Padua, Padua, Italy 4: London Regional Epidemiology Unit, Health Protection Agency, London, UK 5: Centre for Infections, Health Protection Agency, London, UK
Publication date: 2010-11-01
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.
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