Walker, Ian F., Shi, Oumin, Hicks, Joseph P. et al. (13 more authors) (2019) Analysis of loss to follow-up in 4099 multidrug-resistant pulmonary tuberculosis patients. European Respiratory Journal. 1800353. ISSN 1399-3003
Abstract
Loss to follow-up (LFU) of 2 consecutive months contributes to the poor levels of treatment success in multidrug-resistant tuberculosis (MDR-TB) reported by TB programmes. We explored the timing of when LFU occurs by month of MDR-TB treatment and identified patient-level risk factors associated with LFU. We analysed a dataset of individual MDR-TB patient data (4099 patients from 22 countries). We used Kaplan–Meier survival curves to plot time to LFU and a Cox proportional hazards model to explore the association of potential risk factors with LFU. Around one-sixth (n=702) of patients were recorded as LFU. Median (interquartile range) time to LFU was 7 (3–11) months. The majority of LFU occurred in the initial phase of treatment (75% in the first 11 months). Major risk factors associated with LFU were: age 36–50 years (HR 1.3, 95% CI 1.0–1.6; p=0.04) compared with age 0–25 years, being HIV positive (HR 1.8, 95% CI 1.2–2.7; p<0.01) compared with HIV negative, on an individualised treatment regimen (HR 0.7, 95% CI 0.6–1.0; p=0.03) compared with a standardised regimen and a recorded serious adverse event (HR 0.5, 95% CI 0.4–0.6; p<0.01) compared with no serious adverse event. Both patient- and regimen-related factors were associated with LFU, which may guide interventions to improve treatment adherence, particularly in the first 11 months.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 21 Oct 2019 14:00 |
Last Modified: | 16 Oct 2024 16:07 |
Published Version: | https://doi.org/10.1183/13993003.00353-2018 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1183/13993003.00353-2018 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:152176 |
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Filename: Submitted_manuscript_ERJ_Feb_2018.pdf
Description: Submitted manuscript ERJ Feb 2018