ABSTRACT
One hundred rural patient with pulmonary tuberculosis and 74 urban patients were included in the study in order to study the main causes of non-compliance. Crude cumulative incidencia was 42% (73/164). Those factors with the strongest association with non-compliance, independently of its association with other factors, were to live in rural areas (OR 0 10.4; p < 0.001), had not gone to school (analfabet) (OR = 4.5; p < 0.001), and last more than an hour to reach the medical care unit (protector) (OR = 0.40; p = 0.07). No association was found with socioeconomic factors, neither with the patient's knowledge of the disease. Identifying those factors related to non-compliance is important, since non-compliance occurs in the very firsts days of treatment, when the shortage of treatment or giving fewer pills do not work at all. To get a better medial control may be a good way to reach the expected control of the disease.
Subject(s)
Treatment Refusal , Tuberculosis, Pulmonary/drug therapy , Adult , Female , Follow-Up Studies , Humans , Male , Mexico , Middle Aged , Retrospective Studies , Rural Population , Urban PopulationSubject(s)
BCG Vaccine , Tuberculosis/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Mexico , Middle Aged , Preventive Health Services/organization & administration , Socioeconomic Factors , Transients and Migrants , Tuberculosis/prevention & controlABSTRACT
La tuberculosis presenta en las entidades fronterizas del norte de Mexico un problema superior al promedio observado para las otras entidades. Aunque es evidente un descenso en la mortalidad por tuberlosis, particularmente en las formas meningeas en menores de 15 anos, no se puede asegurar que tal efecto obedeza a la vacunacion con BCG ya que se conoce la insuficiente cobertura de inmunizados en el medio rural y en menores de cuatro anos. Se propone integrar en el area un programa de control de la tuberculosis con la participacion de todas las instituciones de salud, con la fijacion de metas epidemiologicas hasta en las localidades mas pequenas y con los cambios y decisiones administrativas antituberculosas en calidad y cantidad verdaderamente utiles. La experiencia que se obtenga en el area con el cambio de estrategia pude extenderse en corto plazo a otras areas del pais, con preferencia a las zonas de alta prevalencia y mortalidad por tuberculosis
