Évaluation des facteurs associés à l’échec du traitement antituberculeux dans le cadre du DOTS (Traitement de brève durée sous surveillance directe) dans le nord de la République islamique d’Iran

Abstract

Tuberculosis treatment failure remains a major health problem in many parts of the Islamic Republic of Iran. This study was conducted to identify the risk factors associated with failure of tuberculosis treatment under the DOTS strategy in two cities of Golestan province. A retrospective cohort study in 2012–2013 was conducted on 167 smearpositive tuberculosis patients monitored under DOTS. Demographic, clinical and treatment outcome factors and social determinants of health were recorded for each patient. Multivariate regression analysis found that the strongest predictors of tuberculosis treatment failure were: being infected with other diseases (OR 9.35; 95% CI: 3.01–29.1), male sex (OR 5.03; 95% CI: 1.58–16.1), Turkoman ethnicity (OR 11.0; 95% CI: 2.00–60.1), family history of tuberculosis (OR 0.21; 95% CI: 0.05–0.96) and household size (OR 1.21; 95% CI: 0.99–1.48). Recommendations include better follow-up for patients with other diseases and facilitating access to treatment, especially for Turkoman patients.