Abstract
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. To determine patient and socio-demographic characteristics associated with default, and the impact of patient support measures on default. Retrospective cohort analysis of 583 MDR-TB patients treated from 1999 to 2006. 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). 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.
Citations
Aug 8, 2013·PloS One·Laura Jean PodewilsMichael P Chen
Nov 14, 2013·PloS One·Maeve K LalorPhilipp du Cros
Feb 20, 2016·Emerging Infectious Diseases·Thelma E TupasiJesus N Sarol
Mar 13, 2016·The Indian Journal of Tuberculosis·Sreenivas Achuthan NairS D Khaparde
Oct 15, 2014·The Journal of Infectious Diseases·Mathieu BastardMaryline Bonnet
Jul 29, 2016·BMC Infectious Diseases·Shona HorterPhilipp du Cros
Jan 12, 2016·PloS One·Changming ZhouBiao Xu
May 26, 2017·PloS One·Erika MohrJennifer Hughes
Jun 30, 2018·BMJ Open Respiratory Research·Sophan SamAnne E Goldfeld
Aug 25, 2015·PloS One·Rajesh D DeshmukhTerrence Q Lo
Aug 15, 2017·Bulletin of the World Health Organization·Jennifer HoGreg J Fox
Dec 29, 2019·Scientific Reports·Habteyes H TolaMillion Molla Sisay
Aug 24, 2019·BMC Health Services Research·Thomas W McNallyConnie M D Wiskin
Nov 26, 2020·PloS One·Shona HorterBeverley Stringer
Apr 28, 2021·Human Resources for Health·Dennis LyakurwaMarleen Heus