SETTING: In the Philippines, programmatic treatment of drug-resistant tuberculosis (TB) was initiated by the Tropical Disease Foundation in 1999 and transitioned to the National TB Program in 2006. OBJECTIVE: To determine patient and socio-demographic characteristics associated with default, and the impact of patient support measures on default. DESIGN: Retrospective cohort analysis of 583 MDR-TB patients treated from 1999 to 2006. RESULTS: A total of 88 (15%) patients defaulted from treatment. The median follow-up time for patients who defaulted was 289 days (range 1-846). In multivariate analysis adjusted for age, sex and previous TB treatment, receiving a greater number of treatment drugs (≥ 5 vs. 2-3 drugs, HR 7.2, 95%CI 3.3-16.0, P < 0.001) was significantly associated with an increased risk of default, while decentralization reduced the risk of default (HR 0.3, 95%CI 0.2-0.7, P < 0.001). CONCLUSION: Improving access to treatment for MDR-TB through decentralization of care to centers near the patient's residence reduced the risk of default. Further research is needed to evaluate the feasibility, impact and cost-effectiveness of decentralized care models for MDR-TB treatment.
SETTING: In the Philippines, programmatic treatment of drug-resistant tuberculosis (TB) was initiated by the Tropical Disease Foundation in 1999 and transitioned to the National TB Program in 2006. OBJECTIVE: To determine patient and socio-demographic characteristics associated with default, and the impact of patient support measures on default. DESIGN: Retrospective cohort analysis of 583 MDR-TB patients treated from 1999 to 2006. RESULTS: A total of 88 (15%) patients defaulted from treatment. The median follow-up time for patients who defaulted was 289 days (range 1-846). In multivariate analysis adjusted for age, sex and previous TB treatment, receiving a greater number of treatment drugs (≥ 5 vs. 2-3 drugs, HR 7.2, 95%CI 3.3-16.0, P < 0.001) was significantly associated with an increased risk of default, while decentralization reduced the risk of default (HR 0.3, 95%CI 0.2-0.7, P < 0.001). CONCLUSION: Improving access to treatment for MDR-TB through decentralization of care to centers near the patient's residence reduced the risk of default. Further research is needed to evaluate the feasibility, impact and cost-effectiveness of decentralized care models for MDR-TB treatment.
Authors: S Keshavjee; I Y Gelmanova; A D Pasechnikov; S P Mishustin; Y G Andreev; A Yedilbayev; J J Furin; J S Mukherjee; M L Rich; E A Nardell; P E Farmer; J Y Kim; S S Shin Journal: Ann N Y Acad Sci Date: 2007-10-22 Impact factor: 5.691
Authors: T E Tupasi; M I D Quelapio; R B Orillaza; C Alcantara; N R C Mira; M R Abeleda; V T Belen; N M Arnisto; A B Rivera; E R Grimaldo; J O Derilo; W Dimarucut; M Arabit; D Urboda Journal: Tuberculosis (Edinb) Date: 2003 Impact factor: 3.131
Authors: Nathan Kapata; Martin P Grobusch; Gershom Chongwe; Pascalina Chanda-Kapata; William Ngosa; Mathias Tembo; Shebba Musonda; Patrick Katemangwe; Matthew Bates; Peter Mwaba; Alimuddin Zumla; Frank Cobelens Journal: Infection Date: 2017-08-04 Impact factor: 3.553
Authors: Jennifer Ho; Anthony L Byrne; Nguyen N Linh; Ernesto Jaramillo; Greg J Fox Journal: Bull World Health Organ Date: 2017-08-01 Impact factor: 9.408
Authors: Rajesh D Deshmukh; D J Dhande; Kuldeep Singh Sachdeva; Achuthan Sreenivas; A M V Kumar; Srinath Satyanarayana; Malik Parmar; Patrick K Moonan; Terrence Q Lo Journal: PLoS One Date: 2015-08-24 Impact factor: 3.240
Authors: Maeve K Lalor; Jane Greig; Sholpan Allamuratova; Sandy Althomsons; Zinaida Tigay; Atadjan Khaemraev; Kai Braker; Oleksander Telnov; Philipp du Cros Journal: PLoS One Date: 2013-11-06 Impact factor: 3.240
Authors: Thelma E Tupasi; Anna Marie Celina G Garfin; Ekaterina V Kurbatova; Joan M Mangan; Ruth Orillaza-Chi; Leilani C Naval; Glenn I Balane; Ramon Basilio; Alexander Golubkov; Evelyn S Joson; Woo-Jin Lew; Vivian Lofranco; Mariquita Mantala; Stuart Pancho; Jesus N Sarol Journal: Emerg Infect Dis Date: 2016-03 Impact factor: 6.883