Factors influencing completion of treatment among tuberculosis patients in Mbarara district Uganda.

Tuberculosis (TB) causes considerable morbidity and mortality globally. The Uganda National Tuberculosis and Leprosy Program (NTLP) was launched in October 1989 in an attempt to coordinate and intensify TB control efforts in the country. The NTLPs main prevention and control strategy consists of case finding and chemotherapy. The retrospective cohort analysis of data on the treatment outcome of 1400 TB patients seen in Mbarara district in 1995 yielded a 56% compliance rate. The operational factors which may be associated with this low rate were subsequently investigated. The following factors were found to be associated with the enhanced completion of treatment: being smear positive using short-course chemotherapy having previously received TB treatment being a return patient for repeat smear being a patient who did not change unit and being a patient who did not change district. Neither gender nor age was associated with compliance. Unconditional logistic regression found previous TB treatment and smear-positive status to be statistically insignificant. Change of health unit after the intensive phase of treatment showed the highest risk of default with an adjusted odds ratio of 22.31. Of the significant factors only the use of standard chemotherapy and change of health unit after the intensive phase can be changed to improve compliance.