Medical and social factors influencing the duration of treatment in patients with newly diagnosed pulmonary tuberculosis

Aim. Assessment of the influence of medical and social factors on the duration of treatment of newly diagnosed patients with pulmonary tuberculosis. Materials and methods. a retrospective longitudinal study was conducted with a survival analysis, taking into account the influence of medical (excluding factors related to the characteristics of the tuberculosis process) and social factors, based on data from patients over the age of 18 who were treated in the Kemerovo Region in 2014−2022. The sample included 6,889 patients who completed effective chemotherapy courses according to regimens I, II, and III. Patients with resistance to rifampicin were excluded. A Cox regression model was used to assess the impact of medical and social factors on the duration of treatment. The analysis was conducted in two stages, including and excluding patients with HIV infection. Results. Treatment duration increased with HIV infection (HR = 0.77; p < 0.001), PAF use (HR = 0.84; p < 0.001), male gender (HR = 0.92; p < 0.002), and rural residence (HR = 0.92; p < 0.017). A shorter duration of treatment was associated with active tuberculosis detection (HR = 1.32; p < 0.001), working patients (HR = 1.22; p < 0.001), older age (HR = 1.005; p < 0.001), and the presence of mental disorders (HR = 1.55; p < 0.001). Conclusion. The results obtained highlight the importance of early diagnosis and socio-organizational support in reducing the duration of treatment for tuberculosis patients. Given the impact of the identified factors, it is necessary to adapt organizational approaches to treatment and increase attention to patient adherence, especially in rural areas and among socially vulnerable groups.

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