Objective  To investigate treatment adherence of pulmonary tuberculosis (TB) patients and identify its influencing factors in less developed areas of Chongqing and provide basis for the next step of developing relevant interventions.

  Methods  A cross-sectional study was conducted in Qianjiang, Fengdu, Kaizhou and Wushan counties (districts) of Chongqing. A questionnaire was used to collect the information about social demographic characteristic, medication, living condition, medical expenditure, and family economic status of the active pulmonary TB patients registered from January 2019 to June 2020 in 4 designated TB hospitals in Chongqing. Analysis was conducted on the treatment adherence of the pulmonary TB patients, and influencing factors were identified by Logistic regression method.

  Results  A total of 339 pulmonary TB patients were included in this study, in whom 51.9% had missed doses during the treatment, 34.2% missed over 10% of the total prescribed doses. The main reasons of missing dose were forgetting medicine taking (45.5%), economic hardship (34.1%), and intolerance to adverse drug reaction (27.8%). Aged 15−29 years, low total medical cost, living near designated TB hospital, having health insurance and assistance, social support and daily directly observed treatment (DOT) were the protective factors for the treatment adherence; however, low education level, adverse drug reactions, low family income, and inadequate health education about TB were the risk factors.

  Conclusion  The treatment adherence rate of TB patients in less developed districts and counties of Chongqing is low. It is important to strengthen health education, encourage and support the TB patients to complete treatment, implement DOT, and improve health resource supply and economic conditions in the less developed areas to improve the TB treatment adherence of local pulmonary TB patients.