Determinants of Treatment Cessation Among Pulmonary Tuberculosis Patients in Khorassan Province of Iran

Abstract

Background: Recognizing of factors involved in the cessation and interruption of a disease like tuberculosis are important and can help us to improve the treatment strategy and educational status of the patients. We assessed the causes of treatment cessation in the patients suffering from pulmonary tuberculosis referred to the tuberculosis Center No.2 in Khorasan Province of Iran during the years March 2003 to March 2005. Methods: A descriptive and retrospective study of casesheets of all pulmonary tuberculosis' patients who were referred to the Mashhad Health Center No. 2 during the years 2003 to 2005 and the variables like age, sex, nationality, outcome of treatment and causes of treatment cessation and interruption were presented with descriptive statistic.Results: The total number of the patients were 659. Of these patients, 534 (81%) were smear positive and 125 (19%) were smear negative. Among the 534 smear-positive patients, 43 (8%) have treatment cessation and interruption. The reasons of treatment interruption were mortality due to T.B in 20 patients (3.7%), drug induced hepatitis in 11 (2%), premature sensation of wellbeing in 2 (0.37%), Hearing problems and vertigo in 2 (0.37%), multi drug resistance (MDR) tuberculosis, in 2 (0.37%), purpura in 1 (0.2%), and exacerbation of renal failure in 2 (0.37%). 438 cases (82%) had total cure. Conclusion:Observation supported the effectiveness of directly observed therapy short course (DOTS) strategy, with first line therapy. The causes of treatment cessation and interruption like drugs' induced hepatitis and premature sensation of wellbeing can be controlled by increasing the awareness of patients about the severity of T.B disease. Efforts to improve patients' understanding of TB disease and related treatment issues may be an important TB control program strategy and should be emphasized at the initiation of therapy and at intervals throughout the treatment course to minimize treatment interruption.