Afshari Mahdi, Aarabi Mohsen, Parsaee Mohammadreza, Nezammahalleh Asghar, Moosazadeh Mahmood
Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran.
Department of Family Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
GMS Hyg Infect Control. 2020 Dec 10;15:Doc33. doi: 10.3205/dgkh000368. eCollection 2020.
Treatment default is one of the main challenges in tuberculosis (TB) control and is considered a major barrier to achieving the sustainable development goals (SDG). Identifying the factors associated with this outcome can help us provide appropriate strategies for decision making. This study investigates the determining factors of treatment default among TB patients. In this case-control study, all 88 TB patients experiencing treatment default during an11-year-period in Mazandaran province, Iran, were compared with 176 randomly selected TB patients without a history of default. Cases and controls were matched based on the year of incidence as well as the treatment center. Related factors of treatment default were determined using multivariate logistic regression models. For men, the odds ratio of experiencing treatment default was 1.67 (p=0.165). In addition, considering ages >64 years as the reference group, the odds ratios for 15- to 24- and 55- to 64-year-olds were 0.95 (p=0.940) and 0.37 (p=0.123), respectively. The corresponding odds ratios for patients 25-34, 35-44 and 45-54 years of age were 1.29 (p=0.547), 1.40 (p=0.472), and 1.39 (p=0.512) respectively. Moreover, the odds ratios for urban residents, patients with a history of imprisonment, a history of previous treatment, adverse treatment effects, previous exposure, non-Iranians and patients with smear-positive TB were 1.72 (p=0.070), 1.24 (p=0.657), 1.47 (p=0.756), 0.99 (p=0.998), 0.98 (p=0.960), 9.29 (p=0.010), and 2.27 (p=0.049) respectively. Non-Iranian nationality and smear-positive TB were detected as predictors of treatment default among patients with tuberculosis.
治疗中断是结核病控制的主要挑战之一，被认为是实现可持续发展目标的主要障碍。确定与这一结果相关的因素有助于我们提供适当的决策策略。本研究调查了结核病患者治疗中断的决定因素。在这项病例对照研究中，将伊朗马赞德兰省11年间出现治疗中断的88例结核病患者与176例随机选择的无治疗中断史的结核病患者进行了比较。病例和对照根据发病年份以及治疗中心进行匹配。使用多变量逻辑回归模型确定治疗中断的相关因素。对于男性，出现治疗中断的比值比为1.67（p = 0.165）。此外，以64岁以上年龄组为参照组，15至24岁和55至64岁年龄组的比值比分别为0.95（p = 0.940）和0.37（p = 0.123）。25至34岁、35至44岁和45至54岁患者的相应比值比分别为1.29（p = 0.547）、1.40（p = 0.472）和1.39（p = 0.512）。此外，城市居民、有监禁史、既往治疗史、不良治疗反应、既往接触史、非伊朗籍以及涂片阳性结核病患者的比值比分别为1.72（p = 0.070）、1.24（p = 0.657）、1.47（p = 0.756）、0.99（p = 0.998）、0.98（p = 0.960）、9.29（p = 0.010）和2.27（p = 0.049）。非伊朗国籍和涂片阳性结核病被检测为结核病患者治疗中断的预测因素。
