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

Abstract

To investigate the factors associated with a higher risk of noncompliance to tuberculosis (TB) treatment in Porto Alegre, Brazil. Methods 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). Results 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 retreatment 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. Conclusion Predictors of poor compliance to TB treatment were low income, abuse of drugs, re-treatment cases and history of smoking.