Frequent return as a novel strategy for tuberculosis treatment adherence

Abstract

OBJECTIVE: Treatment dropout is one of the major obstacles to the control of tuberculosis. The aim of the present study was to evaluate the frequent return strategy instituted at the Tuberculosis Control Program, as well as the program as a whole, identifying and quantifying potential risk factors for dropout. METHODS: The present study was conducted in Ubatuba, Southeastern Brazil. All patients (n=244) notified by the Tuberculosis Control Program in the two years preceding and the two years following the introduction of the frequent return strategy in 1999 were included. We carried out a descriptive analysis of the data and analyzed treatment results and program evaluation indicators. We performed univariate and multivariate analysis in order to identify potential risk factors associated with dropout. We also analyzed the frequent return strategy using chi-squared tests. RESULTS: The strategy reduced the risk of treatment dropout from 12.3% to 4.9%. Risk factors associated with dropout were lack of schooling (OR=3.01; p=0.051), unemployment (OR=3.36; p=0.046), and alcohol dependence (OR=3.56; p=0.014). CONCLUSIONS: The frequent return strategy reduced the risk of treatment dropout, although results did not reach statistical significance due to the small number of dropouts. This strategy may be an alternative for the supervised treatment for all patients recommended by the World Health Organization.