Predictors of noncompliance to pulmonary tuberculosis treatment: An insight from South America

• Published in: PloS one 2018-09, Vol.13 (9), p.e0202593-e0202593
• Main Authors: Madeira de Oliveira, Samanta, Altmayer, Stephan, Zanon, Matheus, Alves Sidney-Filho, Luzielio, Schneider Moreira, Ana Luiza, de Tarso Dalcin, Paulo, Garcez, Anderson, Hochhegger, Bruno, da Silva Moreira, José, Watte, Guilherme
• Format: Article
• Language: English
• Subjects: Abuse; Adult; Analysis; Biology and Life Sciences; Brazil - epidemiology; Care and treatment; Case-Control Studies; Diabetes; Diabetes mellitus; Drug abuse; Drug resistance; Drugs; Female; Health aspects; HIV; Human immunodeficiency virus; Humans; Identification methods; Income; Male; Medicine; Medicine and Health Sciences; Middle Aged; Noncompliance; Patient compliance; Patient Compliance - statistics & numerical data; Patients; People and places; Poverty; Poverty - statistics & numerical data; Public health; Pulmonary tuberculosis; Qualitative research; Radiology; Review boards; Risk; Risk Factors; Smoking; Smoking - epidemiology; Socioeconomic Factors; Subgroups; Surveys and Questionnaires; Tuberculosis; Tuberculosis, Pulmonary - drug therapy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0202593

To investigate the factors associated with a higher risk of noncompliance to tuberculosis (TB) treatment in Porto Alegre, Brazil. We identified 478 adult patients for this case-control study undergoing treatment for confirmed pulmonary TB. Cases (noncompliance) were defined as patients who stopped treatment for more than 30 consecutive days (n = 118). Controls were defined as all patients who completed treatment and were cured (n = 360). Factors associated with noncompliance were calculated with unadjusted and adjusted odds ratio (OR). The rate of noncompliance in our study was 25%. The factors of noncompliance after adjustments in the overall population were, in order of magnitude, living in an area of lower income (OR = 4.35, 95%CI: 2.50-7.58), abuse of drugs (OR = 2.73, 95%CI: 1.47-5.09), nonadherence to a previous treatment regimen (OR = 2.1, 95%CI: 1.28-3.45), and history of smoking (OR = 1.72, 95%CI: 1.00-3.00). Age, race, gender, level of education, HIV infection or diabetes status were not associated with a higher risk of noncompliance. In the subgroup of re-treatment cases, poverty (OR = 2.65; 95%CI = 1.06-6.66), smoking history (OR = 2.94; 95%CI = 1.09-7.92), male gender (OR = 3.25; 95%CI = 1.32-8.0), and younger age (OR = 4.3; 95%CI = 1.15-16.07) were also associated with a higher risk of dropout. Predictors of poor compliance to TB treatment were low income, abuse of drugs, re-treatment cases and history of smoking.