Objetivo: determinar barreras asociadas a la adherencia al tratamiento acortado, estrictamen­te supervisado de tuberculosis (TB) en dos municipios de Colombia. Métodos: estudio de casos (128) y controles (182). Se realizó análisis univariado, bivariado y regresión logística. Resultados: los factores asociados a la no adherencia al tratamiento de TB son: no convivir con familiares (OR=4.54; IC95 % 1.45-14.22), inasistencia a reuniones religiosas (OR=28.17; IC95 % 4.37-181.75), no presentar antecedentes de manejo para una enfermedad mayor a dos semanas (OR=3.37; IC95 % 1.59-7.13), no reconocer que el tratamiento de TB dura hasta seis meses (OR=3.51; IC95 % 1.87-6.59), consumir drogas (OR=3.41; IC95 % 0.95-12.23), falta de suministro ocasional del tratamiento por parte de los servicios de salud (OR=5.53; IC95 % 1.20-5.52). Conclusiones: el diseño y desarrollo de estrategias para asegurar la adherencia al tratamiento de TB debe tener en cuenta, además de los factores individuales comportamentales de los pacientes, los factores sociales y administrativos que afectan su éxito.

Objective: to determine obstacles associated with the adherence to the strictly supervised treat­ment of tuberculosis (TB) in two municipalities of Colombia. Methods: case studies (128) and controls (182). Univariate, bivariate, and logistic regression analyzes were performed. Results: the factors associated with nonadherence to TB treatment were: no cohabitation with relatives (OR = 4.54, 95% CI 1.45-14.22), non-attendance to religious meetings (OR = 28.17, 95% CI 4.37-181.75), no antecedents regarding dealing with an illness lasting over two weeks (OR = 3.37, 95% CI 1.59-7.13), did not recognize that TB treatment lasts for up to six months (OR = 3.51, 95% CI 1.87-6.59), drug use (OR = 3.41 , 95% CI 0.95-12.23), occasional lack of treat­ment supplies by the health services (OR = 5.53, 95% CI 1.20-5.52). Conclusions: The design and development of strategies to ensure adherence to TB treatment must take into account, in addition to the individual behavioral factors of patients, the social and administrative factors that affect their success.