Postgraduate program in Respiratory Medicine, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Porto Alegre, Brazil.
Department of Radiology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Porto Alegre, Brazil.
PLoS One. 2018 Sep 11;13(9):e0202593. doi: 10.1371/journal.pone.0202593. eCollection 2018.
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.
调查巴西阿雷格里港与肺结核（TB）治疗不依从相关的因素。
我们对正在接受确诊肺结核治疗的 478 名成年患者进行了此项病例对照研究。病例（不依从）被定义为停止治疗超过 30 天的患者（n = 118）。对照组被定义为所有完成治疗并治愈的患者（n = 360）。使用未经调整和调整后的比值比（OR）计算与不依从相关的因素。
在我们的研究中，不依从率为 25%。在整个人群中调整后的不依从因素依次为，收入较低地区（OR = 4.35，95%CI：2.50-7.58）、滥用药物（OR = 2.73，95%CI：1.47-5.09）、不遵守以前的治疗方案（OR = 2.1，95%CI：1.28-3.45）和吸烟史（OR = 1.72，95%CI：1.00-3.00）。年龄、种族、性别、教育程度、HIV 感染或糖尿病状况与不依从的风险增加无关。在复治病例亚组中，贫困（OR = 2.65；95%CI = 1.06-6.66）、吸烟史（OR = 2.94；95%CI = 1.09-7.92）、男性（OR = 3.25；95%CI = 1.32-8.0）和年龄较小（OR = 4.3；95%CI = 1.15-16.07）也与更高的辍学风险相关。
肺结核治疗依从性差的预测因素包括低收入、滥用药物、复治病例和吸烟史。
