urban movement and alcohol intake strongly predict defaulting from tuberculosis treatment an operational study城市运动和酒精摄入量强烈预测违约从结核病治疗操作研究.pdf

Urban Movement and Alcohol Intake Strongly Predict Defaulting from Tuberculosis Treatment: An Operational Study 1 3,4 5 6 Ibrahim Sendagire , Maarten Schim Van der Loeff , Andrew Kambugu , Joseph Konde-Lule , Frank Cobelens2,7* 1 Directorate of Health, Kampala Capital City Authority, Kampala, Uganda, 2 Department of Global Health, Academic Medical Center, Amsterdam, The Netherlands, 3 Center for Infection and Immunity Amsterdam, Academic Medical Center, Amsterdam, The Netherlands, 4 Department of Research, Cluster Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands, 5 Infectious Diseases Institute, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, 6 School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda, 7 Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands Abstract Background:High levels of defaulting from treatment challenge tuberculosis control in many African cities. We assessed defaulting from tuberculosis treatment in an African urban setting. Methods: An observational study among adult patients with smear-positive pulmonary tuberculosis receiving treatment at urban primary care clinics in Kampala, Uganda. Defaulting was defined as having missed two consecutive monthly clinic visits while not being reported to have died or continued treatment elsewhere. Defaulting patients were actively followed- up and interviewed. We assessed proportions of patients abandoning treatment with and without the information obtained through active follow-up and we examined associated factors through multivariable logistic regression. Results: Between April 2007 and April 2008,