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Home / The International Journal of Tuberculosis and Lung Disease, Volume 17, Number 4

Non-adherence and drug-related interruptions are risk factors for delays in completion of treatment for tuberculosis

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SETTING: A key program performance objective established by the Centers for Disease Control and Prevention (CDC) is that ≥93% of tuberculosis (TB) cases complete treatment within 12 months.

OBJECTIVE: To determine the rate of and risk factors for delay in anti-tuberculosis treatment completion.

DESIGN: Nested case-control study among TB cases reported to the Tennessee Department of Health between 1 January 2000 and 31 December 2010. Time to complete treatment was calculated using treatment start and stop dates documented in the Tuberculosis Information Management System (TIMS).

RESULTS: Of 2627 cases, 261 (9.9%) required >12 months to complete treatment. In adjusted conditional logistic regression analyses, cavitary disease and positive cultures after 2 months of therapy (OR 5.85, 95%CI 1.98–17.32, P = 0.001), non-adherence (OR 4.13, 95%CI 1.76–9.72, P < 0.001), and interruptions in treatment due to drug-related issues (OR 6.91, 95%CI 3.76–12.70, P < 0.001) were independently associated with delay in completion of TB treatment.

CONCLUSION: From 2000 to 2010, the proportion of TB cases completing treatment within 12 months increased from 84.6% to 94.9%, and remained above the CDC target during 2009–2010. Efforts to improve patient adherence and reduce interruptions in treatment due to anti-tuberculosis drug-related issues could improve the proportion of TB cases completing treatment within 12 months.

Keywords: Mycobacterium tuberculosis; program evaluation; program objective; treatment completion delay; treatment recommendations

Document Type: Research Article

Affiliations: 1: Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA 2: Tennessee Department of Health, Nashville, Tennessee, USA 3: Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA 4: Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; and Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

Publication date: 01 April 2013

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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