Int J Tuberc Lung Dis

SETTINGIn the Philippines, programmatic treatment of drug-resistant tuberculosis (TB) was initiated by the Tropical Disease Foundation in 1999 and transitioned to the National TB Program in 2006.OBJECTIVETo determine patient and socio-demographic characteristics associated with default, and the impact of patient support measures on default.DESIGNRetrospective cohort analysis of 583 MDR-TB patients treated from 1999 to 2006.RESULTSA total of 88 (15%) patients defaulted from treatment. The median follow-up time for patients who defaulted was 289 days (range 1\u2013846). In multivariate analysis adjusted for age, sex and previous TB treatment, receiving a greater number of treatment drugs ( 655 vs. 2\u20133 drugs, HR 7.2, 95%CI 3.3\u201316.0, P < 0.001) was significantly associated with an increased risk of default, while decentralization reduced the risk of default (HR 0.3, 95%CI 0.2\u20130.7, P < 0.001).CONCLUSIONImproving access to treatment for MDR-TB through decentralization of care to centers near the patient\u2019s residence reduced the risk of default. Further research is needed to evaluate the feasibility, impact and cost-effectiveness of decentralized care models for MDR-TB treatment.CC999999/Intramural CDC HHS/United States2015-10-23T00:00:00Z22584124PMC46160158412vault:1342