Factors Related to Default and Failure Treatment of Multidrug-Resistant TB Patients in the Provinces under the Responsibility of the Office of Disease Prevention and Control Region 7, Ubon Ratchathani

Abstract

The objectives of this research were to study the factors related to default and failure treatment of multidrug resistant tuberculosis (MDR-TB) patients and analyze the problems associated with the provi-sion of treatment services by health facilities and the communities, as well as to the socio-economic problems of the patients. It was conducted in 7 provinces under the responsibility of the Office of Disease Prevention and Control Region 7, Ubol Ratchathani Province, Thailand. The study samples were 70 TB patients with laboratory findings showed resistant to INH and Rifampicin, and were diagnosed as MDR-TB and registered for treatment by physicians during the year 2002-2014. They were purposively cat-egorized into 2 groups: one with successful treatment (35 cases) and the other with failure treatment (35 cases). Data were collected by questionnaire interviews; and were analyzed by binary logistic regression. It was found that the majority of patients were male (75.5%), and aged 40-49 years old (60.5%). The factors of the perception on risk and benefit of care and treatment, access to services, social support, self-care and prevention of drug resistance, and income during treatment of MDR-TB altogether were able to predict 20.7% of the default and failure treatment of MDR-TB; and the accuracy of the prediction was at 67.1%. The factor of no income during treatment was significantly associated with default and treatment failure (p<0.05). The ratio of default and failure treatment between the patients who had no income and those who had income during treatment was 2.88. The main reason for the failure was the lack of income to support the family during the treatment period and for transportatiom expense to the hospital. Thus, household economy was identified to be the most important factor for the default and failure treatment of the MDR-TB patients. Hence, proper care and treatment of MDR-TB patient requires good understanding of the socio-economic condition of the patients; and the treatment program should be handled by multidisciplinary team with participation of the communities to ensure the continuation of the DOTS services to the MDR-TB patients.