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Reasons for defaulting from drug-resistant tuberculosis treatment in Armenia: a quantitative and qualitative study | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Reasons for defaulting from drug-resistant tuberculosis treatment in Armenia: a quantitative and qualitative study

Sanchez-Padilla E, Marquer C, Kalon S, Qayyum S, Hayrapetyan A, Varaine FFV, Bastard M, Bonnet MMB
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Abstract
SETTING
Armenia, a country with a high prevalence of drug-resistant tuberculosis (DR-TB).

OBJECTIVE
To identify factors related to default from DR-TB treatment in Yerevan.

DESIGN
Using a retrospective cohort design, we compared defaulters with patients who were cured, completed or failed treatment. Patients who initiated DR-TB treatment from 2005 to 2011 were included in the study. A qualitative survey was conducted including semi-structured interviews with defaulters and focus group discussions with care providers.

RESULTS
Of 381 patients, 193 had achieved treatment success, 24 had died, 51 had failed treatment and 97 had defaulted. The number of drugs to which the patient was resistant at admission (aRR 1.16, 95%CI 1.05–1.27), the rate of treatment interruption based on patient's decision (aRR 1.03, 95%CI 1.02–1.05), the rate of side effects (aRR 1.18, 95%CI 1.09–1.27), and absence of culture conversion during the intensive phase (aRR 0.47, 95%CI 0.31–0.71) were independently associated with default from treatment. In the qualitative study, poor treatment tolerance, a perception that treatment was inefficient, lack of information, incorrect perception of being cured, working factors and behavioural problems were factors related to treatment default.

CONCLUSION
In addition to economic reasons, poor tolerance of and poor response to treatment were the main factors associated with treatment default.

Countries

Armenia

Subject Area

antibiotic resistancetuberculosisantimicrobial resistance

Languages

English
DOI
10.5588/ijtld.13.0369
Published Date
01 Feb 2014
PubMed ID
24429307
Journal
International Journal of Tuberculosis and Lung Disease
Volume | Issue | Pages
Volume 18, Issue 2, Pages 160-167
Issue Date
2014-02-01
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