{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:24:08Z","timestamp":1771478648410,"version":"3.50.1"},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T00:00:00Z","timestamp":1484524800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>The goals of this article are: (i) to understand how individual characteristics affect the likelihood of patients defaulting their pulmonary tuberculosis (PTB) treatment regimens; (ii) to quantify the predictive capacity of these risk factors; and (iii) to quantify and map spatial variation in the risk of defaulting. We used logistic regression models and generalized additive models with a spatial component to determine the odds of default across continental Portugal. We focused on new PTB cases, diagnosed between 2000 and 2013, and included some individual information (sex, age, residence area, alcohol abuse, intravenous drug use, homelessness, HIV, imprisonment status). We found that the global default rate was 4\u00b788%, higher in individuals with well-known risk profiles (males, immigrants, HIV positive, homeless, prisoners, alcohol and drug users). Of specific epidemiological interest was that our geographical analysis found that Portugal's main urban areas (the two biggest cities) and one tourist region have higher default rates compared to the rest of the country, after adjusting for the previously mentioneded risk factors. The challenge of treatment defaulting, either due to other individual non-measured characteristics, healthcare system failure or patient recalcitrance requires further analysis in the spatio-temporal domain. Our findings suggest the presence of significant within-country variation in the risk of defaulting that cannot be explained by these classical individual risk factors alone. The methods we advocate are simple to implement and could easily be applied to other diseases.<\/jats:p>","DOI":"10.1017\/s0950268816003307","type":"journal-article","created":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T11:06:17Z","timestamp":1484564777000},"page":"1130-1134","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Who are the patients that default tuberculosis treatment? \u2013 space matters!"],"prefix":"10.1017","volume":"145","author":[{"given":"C.","family":"NUNES","sequence":"first","affiliation":[]},{"given":"R.","family":"DUARTE","sequence":"additional","affiliation":[]},{"given":"A. M.","family":"VEIGA","sequence":"additional","affiliation":[]},{"given":"B.","family":"TAYLOR","sequence":"additional","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2017,1,16]]},"reference":[{"key":"S0950268816003307_ref10","article-title":"Epidemiology of tuberculosis in big cities of the European Union and European Economic Area countries","volume":"19","author":"De","year":"2014","journal-title":"Eurosurveillance"},{"key":"S0950268816003307_ref14","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6939-5-2"},{"key":"S0950268816003307_ref2","unstructured":"World Health Organization. Definitions and reporting framework for tuberculosis: 2013 revision. Geneva: World Health Organization, 2013."},{"key":"S0950268816003307_ref8","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1183\/09031936.00030612","article-title":"Tuberculosis treatment outcome monitoring in European Union countries: systematic review","volume":"41","author":"Van","year":"2013","journal-title":"European Respiratory Journal"},{"key":"S0950268816003307_ref5","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00103504"},{"key":"S0950268816003307_ref9","first-page":"458","article-title":"Current status of treatment completion and fatality among tuberculosis patients in Spain","volume":"8","author":"Cayla","year":"2004","journal-title":"International Journal of Tuberculosis and Lung Disease"},{"key":"S0950268816003307_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-140"},{"key":"S0950268816003307_ref4","unstructured":"R Core Team. R: A language and environment for statistical computing (https:\/\/www.R-project.org\/). Accessed 7 April 2016."},{"key":"S0950268816003307_ref12","volume-title":"Geographic Variations in Health Care: What Do We Know and What Can Be Done to Improve Health System Performance?","year":"2014"},{"key":"S0950268816003307_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(96)00402-0"},{"key":"S0950268816003307_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-7-291"},{"key":"S0950268816003307_ref13","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.06.035568"},{"key":"S0950268816003307_ref1","first-page":"70","article-title":"The fate of cases of pulmonary tuberculosis under various treatment programmes","volume":"53","author":"Grzybowski","year":"1978","journal-title":"Bulletin of the International Union Against Tuberculosis"},{"key":"S0950268816003307_ref3","doi-asserted-by":"crossref","unstructured":"Wood SN . Generalized Additive Models: An Introduction with R. Chapman and Hall\/CRC, 2006.","DOI":"10.1201\/9781420010404"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268816003307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T11:59:34Z","timestamp":1631015974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268816003307\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,16]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["S0950268816003307"],"URL":"https:\/\/doi.org\/10.1017\/s0950268816003307","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,16]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2017\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}