[Social risk factors for noncompliance with tuberculosis treatment in Pontevedra [Spain]].

OBJECTIVE

To determine the prevalence and characteristics of social risk factors (SRF) for noncompliance with treatment in patients with tuberculosis (TB) in Pontevedra.

METHODS

We performed a descriptive analysis of patients with TB and SRF diagnosed between 1996 and 2002. A patient was considered as having SRF if he or she was socially isolated (alcoholism, intravenous drug use, prison inmate, homelessness or social maladjustment) or was an immigrant. The prevalence, annual trend of SRF and patient outcomes were calculated. The influence of direct observation of treatment administration on the outcome of patients with SRF was also analyzed.

RESULTS

Of 775 patients with TB, 156 (20.1%) had at least one SRF. Eighty-six patients were alcoholic, 41 were intravenous drug users, 24 were immigrants, 11 were homeless, 11 showed social maladjustment and 10 were prison inmates. The presence of SRF among TB patients showed no tendency to increase or decrease during the study period, except for the increasing number of immigrants (chi 2 for lineal tendency = 12.24; p = 0.005). Final outcomes were significantly better in patients without SRF (90.4 vs 70.8% of satisfactory final outcomes; p < 0.001). Direct observation of treatment did not increase satisfactory outcomes in patients with SRF.

CONCLUSIONS

Patients with TB and SRF have a significantly higher proportion of unsatisfactory final outcomes. The presence of SRF is relatively low in our environment. The number of immigrants from countries with a high prevalence of TB shows an incipient tendency to increase. This finding should be taken into account to achieve better control of the disease.