M E Rutherford1, P C Hill, W Maharani, H Sampurno, R Ruslami. 1. Centre for International Health, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand; Health Research Unit, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
Abstract
SETTING: Defaulting from anti-tuberculosis treatment hinders tuberculosis (TB) control. OBJECTIVE: To identify potential defaulters. DESIGN: We conducted a cohort study in newly diagnosed Indonesian TB patients. We administered a questionnaire, prospectively identified defaulters (discontinued treatment ≥ 2 weeks) and assessed risk factors using Cox's regression. RESULTS: Of 249 patients, 39 (16%) defaulted, 61% in the first 2 months. Default was associated with liver disease (HR 3.40, 95%CI 1.02-11.78), chest pain (HR 2.25, 95%CI 1.06-4.77), night sweats (HR 1.98, 95%CI 1.03-3.79), characteristics of the head of the household (self-employed, HR 2.47, 95%CI 1.15-5.34; patient's mother, HR 7.72, 95%CI 1.66-35.88), household wealth (HR 4.24, 95%CI 1.12-16.09), walking to clinic (HR 4.53, 95%CI 1.39-14.71), being unaccompanied at diagnosis (HR 30.49, 95%CI 7.55-123.07) or when collecting medication (HR 3.34, 95%CI 1.24-8.98) and low level of satisfaction with the clinic (HR 3.85, 95%CI 1.17-12.62) or doctors (HR 2.45, 95%CI 1.18-5.10). Health insurance (HR 0.24, 95%CI 0.07-0.74) and paying for diagnosis (HR 0.14, 95%CI 0.04-0.48) were protective. CONCLUSION: Defaulting is common and occurs early. Interventions that improve clinic services, strengthen patient support and increase insurance coverage may reduce default in Indonesia.
SETTING: Defaulting from anti-tuberculosis treatment hinders tuberculosis (TB) control. OBJECTIVE: To identify potential defaulters. DESIGN: We conducted a cohort study in newly diagnosed Indonesian TB patients. We administered a questionnaire, prospectively identified defaulters (discontinued treatment ≥ 2 weeks) and assessed risk factors using Cox's regression. RESULTS: Of 249 patients, 39 (16%) defaulted, 61% in the first 2 months. Default was associated with liver disease (HR 3.40, 95%CI 1.02-11.78), chest pain (HR 2.25, 95%CI 1.06-4.77), night sweats (HR 1.98, 95%CI 1.03-3.79), characteristics of the head of the household (self-employed, HR 2.47, 95%CI 1.15-5.34; patient's mother, HR 7.72, 95%CI 1.66-35.88), household wealth (HR 4.24, 95%CI 1.12-16.09), walking to clinic (HR 4.53, 95%CI 1.39-14.71), being unaccompanied at diagnosis (HR 30.49, 95%CI 7.55-123.07) or when collecting medication (HR 3.34, 95%CI 1.24-8.98) and low level of satisfaction with the clinic (HR 3.85, 95%CI 1.17-12.62) or doctors (HR 2.45, 95%CI 1.18-5.10). Health insurance (HR 0.24, 95%CI 0.07-0.74) and paying for diagnosis (HR 0.14, 95%CI 0.04-0.48) were protective. CONCLUSION: Defaulting is common and occurs early. Interventions that improve clinic services, strengthen patient support and increase insurance coverage may reduce default in Indonesia.
Authors: Willy Ssengooba; Bruce Kirenga; Catherine Muwonge; Steven Kyaligonza; Samuel Kasozi; Frank Mugabe; Martin Boeree; Moses Joloba; Alphonse Okwera Journal: Afr Health Sci Date: 2016-12 Impact factor: 0.927
Authors: Cylia Nkechi Iweama; Olaoluwa Samson Agbaje; Prince Christian Ifeanachor Umoke; Chima Charles Igbokwe; Eyuche Lawretta Ozoemena; Nnenna Lois Omaka-Amari; Benjamin Mudi Idache Journal: SAGE Open Med Date: 2021-01-30