Abstract
Background: Despite great effort to control tuberculosis (TB), low treatment adherence threatens the success of drug therapy, increases the risk of TB transmission, and leads to the development of drug resistance. The present study assessed anti-TB treatment adherence in sputum smear-positive TB patients and examined the risk factors for poor patient adherence to identify targets for intervention. Methods: We monitored and followed up TB patients who were diagnosed between July 2014 and June 2015 in Xinjiang, China. A total of 8289 sputum smear-positive TB patients were included in this study. All patients registered their information during the first hospital visit or with the Centers for Disease Control, had regular follow-up visits, and accepted the anti-TB treatment. Insufficient re-examination adherence was defined as undergoing fewer than the recommended three sputum smear examinations during the treatment course. Results: Among 8289 patients, 3827 men (84.4% of male patients) and 3220 women (85.7% of female patients) had good adherence during treatment follow-up. 1242 patients (15.0%) did not complete regular follow-up. 332 (4.0%) patients lost contact. An adjusted logistic regression model showed that ethnicity, household address, treatment classification, patient source, and the actual management were significantly associated with non-adherence. Conclusion: The Xinjiang TB epidemic situation remains grim. Smear-positive patients had a higher proportion of non-adherence, which increased treatment difficulties and the risk of death from TB. Relevant medical departments should strengthen their supervision and interventions during the TB treatment process to improve patient adherence to anti-TB treatment.
Highlights
Tuberculosis (TB) causes signi cant morbidity and mortality and remains a major global health problem.[1]
Treatment adherence was compared among different subgroups using a univariate logistic regression analysis. We found that those patients with poor adherence were elderly (P < 0.01), those from a oating population (P < 0.05), manual laborers (P < 0.01), those who were derived from referral and tracking (P < 0.01), or those who were self-medicated and
Type III TB patients accounted for 99.1% of the study population; 1.4% of the patients were diagnosed by health examination, whereas 28.7% and 38.7% were diagnosed by illness or referral
Summary
Tuberculosis (TB) causes signi cant morbidity and mortality and remains a major global health problem.[1]. There were 4.3 million more actual cases of disease than reported.[2] Currently, approximately one-third of the world's population is infected with TB bacteria.[3] TB can have far-reaching economic and social consequences among infected people and their household members, in developing countries.[4]. The present study assessed anti-TB treatment adherence in sputum smear-positive TB patients and examined the risk factors for poor patient adherence to identify targets for intervention. A total of 8289 sputum smear-positive TB patients were included in this study. All patients registered their information during the first hospital visit or with the Centers for Disease Control, had regular follow-up visits, and accepted the anti-TB treatment. Smear-positive patients had a higher proportion of non-adherence, which increased treatment difficulties and the risk of death from TB. Relevant medical departments should strengthen their supervision and interventions during the TB treatment process to improve patient adherence to anti-TB treatment
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