Delay and completion of tuberculosis treatment: a cross-sectional study in the West Midlands, UK

J Public Health (Oxf). 2013 Mar;35(1):12-20. doi: 10.1093/pubmed/fds046. Epub 2012 Jun 21.

Abstract

Background: TB remains a significant problem in the UK with the West Midlands having the highest incidence after London. Treatment is usually for a minimum of 6 months and requires a high level of compliance. We investigated potential determinants of delays and completion of treatment for tuberculosis (TB) in the West Midlands, UK.

Methods: We used data on 4840 patients with TB in the West Midlands from the Enhanced Tuberculosis Surveillance database from 1 January 2005 to 1 October 2010. We used regression models to investigate the cross-sectional association between sociodemographic and clinical risk factors and the timeliness and completion of TB treatment.

Results: Patients with TB waited 82 days on average from symptom onset to treatment initiation. Female patients spent 6% longer time than males before receiving treatment [95% confidence interval (CI): 1.2-11.6%, P = 0.015]. Asian/Asian British patients were 11 times more likely to complete treatment than White patients (adjusted odds ratio: 11.4, 95% CI: 1.31-100.3, P = 0.028).

Conclusions: Females in the West Midlands took longer time to receive TB treatment than males, representing a health inequality that could be addressed through gender-sensitive awareness raising programmes. White patients were less likely to complete treatment than Asian/Asian British patients; additional support is needed in this group.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use*
  • Asian Continental Ancestry Group
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • England / epidemiology
  • European Continental Ancestry Group
  • Female
  • Health Planning Guidelines
  • Health Services Accessibility*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medication Adherence / ethnology
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors
  • Time Factors
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / epidemiology
  • Young Adult

Substances

  • Antitubercular Agents