Abandono del tratamiento antituberculoso en la población inmigrante: la movilidad y la falta de apoyo familiar / Antituberculosis treatment default among the immigrant population: mobility and lack of family support

Objetivo: Conocer los resultados del tratamiento antituberculoso entre la población inmigrante e identificar las variables asociadas a su abandono. Métodos: Estudio de cohortes prospectivo que incluye los casos de tuberculosis en población inmigrante, mayor de 15 años, diagnosticados en 15 hospitales públicos de la Comunidad de Madrid, durante el año 2003. En primer lugar se realizó un estudio descriptivo y posteriormente se efectuó un análisis bivariado/multivariado mediante regresiones logísticas. La variable dependiente fue abandono del tratamiento frente a tratamiento satisfactorio. Resultados: De 296 casos, el 75,0% tuvo un resultado del tratamiento satisfactorio; abandono 8,4%; muerte 2%; fracaso 0,7%; traslados 7,1% y pérdidas de información 6,8%. Las variables que se asociaron al abandono del tratamiento de forma independiente fueron el sexo (ref. varón) (odds ratio [OR]: 0,18; intervalo de confianza del 95% [IC95%]: 0,03–0,95), la convivencia con familiares (ref no) (OR: 0,23; IC95%: 0,08–0,66) y desplazarse a otra comunidad autónoma (OR: 5,52; IC95%: 1,17–25,93) frente a no desplazarse. Conclusiones: Es necesario mejorar los resultados del tratamiento antituberculoso en la población inmigrante. Para ello se debe mejorar la coordinación sanitaria en caso de desplazamiento y dirigir estrategias que faciliten el cumplimento del tratamiento entre las personas que no conviven con sus familiares (AU)

Objective: To identify antituberculosis treatment outcomes among the immigrant population and determine the variables associated with treatment default. Methods: We performed a prospective cohort study that included cases of tuberculosis in immigrants older than 15 years diagnosed in 15 public hospitals of the Community of Madrid in 2003. Firstly, a descriptive study was performed. Subsequently, a bivariate/multivariate analysis was performed using logistic regressions. The dependent variable was treatment default vs successful treatment. Results: Of 296 cases, 75.0% successfully completed the treatment, 8.4% defaulted, 2% died, 0.7% showed treatment failure, and 7.1% transferred out; information loss occurred in 6.8%. The variables independently associated with treatment default were female sex (odds ratio [OR]: 0.18; 95% confidence interval [95%CI]: 0.03–0.95), living with relatives (0.23 [0.08–0.66]) and moving to another autonomous community (5.52 [1.17–25.93]) compared with not moving. Conclusions: Antituberculosis treatment outcomes in the immigrant population need to be improved. To achieve this aim, healthcare coordination should be improved in the mobile population and strategies to increase treatment compliance among persons not living with relatives are required (AU)

[Antituberculosis treatment default among the immigrant population: mobility and lack of family support]. / Abandono del tratamiento antituberculoso en la población inmigrante: la movilidad y la falta de apoyo familiar.

OBJECTIVE: To identify antituberculosis treatment outcomes among the immigrant population and determine the variables associated with treatment default. METHODS: We performed a prospective cohort study that included cases of tuberculosis in immigrants older than 15 years diagnosed in 15 public hospitals of the Community of Madrid in 2003. Firstly, a descriptive study was performed. Subsequently, a bivariate/multivariate analysis was performed using logistic regressions. The dependent variable was treatment default vs successful treatment. RESULTS: Of 296 cases, 75.0% successfully completed the treatment, 8.4% defaulted, 2% died, 0.7% showed treatment failure, and 7.1% transferred out; information loss occurred in 6.8%. The variables independently associated with treatment default were female sex (odds ratio [OR]: 0.18; 95% confidence interval [95%CI]: 0.03-0.95), living with relatives (0.23 [0.08-0.66]) and moving to another autonomous community (5.52 [1.17-25.93]) compared with not moving. CONCLUSIONS: Antituberculosis treatment outcomes in the immigrant population need to be improved. To achieve this aim, healthcare coordination should be improved in the mobile population and strategies to increase treatment compliance among persons not living with relatives are required.