Survival analysis of treatment defaulters among tuberculosis patients in government medical college and hospital, Aurangabad

Abstract

Context: Tuberculosis (TB) patients who do not complete treatment pose a potential public health risk through disease reactivation, increased transmission, and development of drug resistance. Aims: (1) To determine the duration TB patients stay in the treatment before defaulting. (2) Factors associated with defaulters who had been treated in Government Medical College and Hospital (GMCH), Aurangabad. Setting and Design: The study was conducted at TB Unit of GMCH, Aurangabad, and community. This was a retrospective cohort study. Materials and Methods: Based on record review of 440 bacteriological-confirmed TB patients enrolled in the TB Unit of GMCH, Aurangabad, in 2015 from January 1, to December 31, we collected information on potential risk factors of all confirmed cases by primary and secondary data. For survival analysis, outcome of interest was treatment defaulter. Kaplan–Meier curves, log-rank test, and Cox-proportional hazard regression analysis were used to model outcome of interest. Statistical Analysis Used: Statistical analysis is performed using SPSS version 17. Results: Out of total 440 TB patients registered, 13 patients got defaulted in 2015. Overall mean time of default was 279 days, with 276 days for males against 279 days for females. Many patients interrupted treatment during continuation phase. Treatment defaulters had an association with gender, category at the initiation of treatment, HIV status, smoking, and alcohol consumption. Conclusion: Targeted intervention with the goal toward adherence in persons abusing smoking and alcohol is recommended. Necessary actions need to be initiated in the program to strengthen the follow-up of patients and to bring behavioral changes by proper counseling.

Keywords

• Cox proportional hazard
• log-rank
• survival analysis
• treatment defaulters