Adherence to Pulmonary Tuberculosis Treatment In Murang’a County, Kenya

Non-adherence to Tuberculosis treatment is a major barrier for TB control programs because incomplete treatment may result in prolonged infectiousness, drug resistance, relapse and death. Successful treatment of TB involves taking anti TB drugs for at least six months as per the doctors advise. Currently, Tuberculosis has become a resurgent public Health problem in developing countries and is the leading cause of death from any single infectious agent. The purpose of the study was to identify factors contributing to non-adherence to TB treatment amongst pulmonary TB patients in Maragua Sub-County of Murang’a County. The objectives included were to determine the social-economic related, healthcare-related, patient-related and disease and medicine related factors associated with non-adherence of TB treatment amongst patients in Murang’a County. The study was guided by the Health Belief model as the theoretical framework. A cross-sectional survey study design was used. Census method was used and all 270 people were considered. Data was collected using a mixed method approach of interview guides, questionnaires and Focus Group Discussions. A total of 270 adult Pulmonary TB patients, amongst whom 59 (47%) were adherents and 67(53%) non adherents with TB treatment, who received treatment in 2017 and had completed treatment, Community Health workers, and Health Personnel in the TB clinic participated in the study. Data was entered to EPI INFO version 3.5.3 and analysed using Statistical Package for Social Sciences (SPSS) version 22. Multiple logistic regressions was used to identify associations and to control potential confounding variables. Chi Square was used to test independence of categorical variables with p value of less than 0.05 at 95% confidence interval being considered significant. Data presentation was done using figures and tables. From the results of the study only the distance taken to collect drugs in the health facility was found to be associated with non-adherence to TB treatment (n=9 ,13%). The study recommends that measures should be undertaken so as to reduce the non-adherence level to TB treatment by ensuring anti-Tb treatment is accessible to patients at the nearest Health facility from their residence. Additionally, the study proposes that the patients should be sensitized on the importance of adherence to TB drug mediction. Interventions with Health promotion initiatives emphasizing the benefits of treatment adherence should be enhanced in the communities by further large scale multicentred studies and that an enabling environment which is conducive for good patient interactions should be created. The study concludes that there are challenges facing adherence of TB treatment which ought to be addressed. The study, suggests that measures to improve drug adherence such as improving health conditions, increasing the availability of drugs and conducting health educations to the patients is essential in minimizing the drug non-adherence to TB drugs.

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PERAN SARANA PELAYANAN KESEHATAN TERHADAP KEJADIAN MALARIA DI KECAMATAN SILIAN RAYA KABUPATEN MINAHASA TENGGARA

Jurnal e-Biomedik ◽

10.35790/ebm.3.1.2015.7422 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Meilany Tangkilisan ◽

Angle Sorisi ◽

Josef S. B. Tuda

Keyword(s):

Public Health ◽

Health Care ◽

Health Problem ◽

Health Workers ◽

Public Health Problem ◽

Malaria Prevention ◽

Health Care Facilities ◽

Survey Study ◽

Care Facilities ◽

Descriptive Survey

Abstract: The problem of public health, especially in developing coutries such as Indonesia, is based on the physical aspects such as health facilities, the treatment of disease, and non physical aspects related to the health problem. Malaria is still a public health problem because it often creates exrtraordinary events, which has great impact on quality on life and economy, and may result death. The main keys of reducing the incidence of malaria especially in high endemic areas are prevention and treatment. This study aimed to determine the role of health care facilities on the incidence of malaria in Silian Raya sub-district of Southheast Minahasa district. This was a descriptive survey study. The population was the community in Silian Raya sub-district of Southeast Minahasa district with total samples 194 respondents. The results showed that the counseling done by health workers was at the most 2 times (39.2%). Spraying insecticide by health workers was 1 time (41.8%). People that used the available health care facilities in Silian Raya sub-district, the health center, were 51.0%.Keywords: malaria, prevention, treatmentAbstrak: Masalah kesehatan masyarakat terutama di negara-negara berkembang seperti Indonesia didasarkan pada, aspek fisik seperti sarana kesehatan dan pengobatan penyakit, dan aspek non fisik yang menyangkut masalah kesehatan.Malaria masih merupakan masalah kesehatan masyarakat karena sering menimbulkan Kejadian Luar Biasa (KLB), berdampak luas terhadap kualitas hidup dan ekonomi, serta dapat mengakibatkan kematian. Dalam upaya mengurangi angka kejadian malaria terutama di daerah endemis tinggi, upaya pencegahan dan pengobatan merupakan kunci utama. Tujuan penelitian ini untuk mengetahui peran sarana pelayanan kesehatan terhadap kejadian malaria di Kecamatan Silian Raya Kabupaten Minahasa Tenggara. Jenis penelitian ini adalah survey yang bersifat deskriptif. Populasi penelitian adalah masyarakat di Kecamatan Silian Raya Kabupaten Minahasa Tenggara dengan jumlah sampel 194 responden. Hasil penelitian menunjukkan penyuluhan yang dilakukan oleh tenaga kesehatan tertinggi 2 kali (39,2%). Penyemprotan insektisida oleh tenaga kesehatan tertinggi 1 kali (41,8%) dan masyarakat yang langsung memanfaatkan sarana pelayanan kesehatan yang tersedia di Kecamatan Silian Raya yaitu Puskesmas (51,0%).Kata kunci: malaria, pencegahan, pengobatan

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RISK FACTORS IN PULMONARY TUBERCULOSIS TREATMENT FAILURE

The Indonesian Journal of Public Health ◽

10.20473/ijph.v16i1.2021.12-22 ◽

2021 ◽

Vol 16 (1) ◽

pp. 12

Author(s):

Dyan Kunthi Nugrahaeni ◽

Lala Rosmalaningrum

Keyword(s):

Risk Factors ◽

Medication Adherence ◽

Pulmonary Tuberculosis ◽

Nutritional Status ◽

Treatment Failure ◽

Family Support ◽

Tuberculosis Treatment ◽

Pulmonary Tb ◽

Tb Treatment ◽

Nutritional Guidance

Pulmonary tuberculosis (TB) is a global health problem and has become the leading cause of death. Tuberculosis eradication is inhibited due to the tendency of patients to not complete the TB treatment. The purpose of this study was to determine the relationship between knowledge, nutritional status, oral medication adherence, and family support as risk factors for pulmonary tuberculosis treatment failure. The design of this study is that of case-control, and this study involved samples of pulmonary TB patients who were declared not cured after treatment (14 people), and control samples of pulmonary TB patients who were declared cured (28 people). The data were obtained through measurements of nutritional status and interviews, while treatment failure was based on data from the TB 01 form. Data was analysed using univariable and bivariable analyses, and the magnitude of risk factors was based on the odds ratio (OR) and 95% confidence interval (CI). The results showed that the factors associated with failure of pulmonary TB treatment are knowledge (p = 0.022; OR = 6.6; 95% CI = 1.48 - 29.36), nutritional status (p = 0.005; OR = 9.16; 95% CI = 2.11 - 39.85), and medication adherence (p = 0.003; OR =11.0; 95% CI = 2.37 - 54.14), whereas the unrelated factor is family support (p = 0.47). It is recommended to provide counselling, nutritional guidance, medication assistance, and family support to patients during the treatment period for pulmonary tuberculosis. Keywords: treatment failure, knowledge, nutritional status, compliance

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The Factors associated with the unsuccessful tuberculosis treatment of hill tribe patients in Thailand

The Journal of Infection in Developing Countries ◽

10.3855/jidc.12029 ◽

2020 ◽

Vol 14 (01) ◽

pp. 42-47

Author(s):

Siriyaporn Khunthason ◽

Jaranit Kaewkungwal ◽

Wirichada Pan-Ngum ◽

Chusak Okascharoen ◽

Tawatchai Apidechkul ◽

...

Keyword(s):

Success Rate ◽

Treatment Success ◽

Public Health Problem ◽

Antiretroviral Drugs ◽

Tuberculosis Treatment ◽

Treatment Success Rate ◽

Factors Associated ◽

Tb Treatment ◽

Hill Tribe ◽

The Hill

Introduction: Tuberculosis (TB) remains a serious public-health problem worldwide. The successful tuberculosis treatment was in low rate among the hill tribes in Thailand. This study aimed to determine factors associated with the unsuccessful tuberculosis treatment among the hill tribe TB patients in northern Thailand. Methodology: A retrospective cohort study was conducted using secondary data from the national TB reporting system. Data of newly registered hill tribe patients with TB receiving treatment were obtained from 18 government hospitals in Chiang Rai province, during 2014–2017. TB treatment outcomes and factors associated with unsuccessful were determined. Results: A total of 770 hill tribe patients with TB registered during the study period. The majority were males aged 25–64 years. About 80% of the patients lived in rural areas and 53.9% worked in agriculture. The overall TB treatment success rate was 80.4%. Two factors were associated with unsuccessful TB treatment: ages 25–44 and ages 45–64 (aOR 3.14 (1.03–9.55) and 3.02 (1.01–9.03), respectively) and receiving antiretroviral drugs (proxy of HIV infection) (aOR 2.30 (1.02–5.15)). Conclusion: Although the TB treatment success rate among hill tribe patients did not reach the national goal, it was still higher than that of other Thai TB patients in the area. In Thailand, hill tribe people can access health services free-of-charge under the national health insurance. This could influence the successful treatment. However, some barriers need to be considered, such as the high default rate and high death rate among those with HIV coinfection.

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Kepatuhan menelan obat, merokok dan resiko kegagalan konversi (BTA positif) pada pasien tuberculosis

HOLISTIK JURNAL KESEHATAN ◽

10.33024/hjk.v14i4.1600 ◽

2021 ◽

Vol 14 (4) ◽

pp. 581-589

Author(s):

Mariawati Mariawati ◽

Khoidar Amirus ◽

Marliyana Marliyana

Keyword(s):

Medication Adherence ◽

Pulmonary Tuberculosis ◽

Health Workers ◽

Treatment Compliance ◽

Patient Treatment ◽

Sputum Smear ◽

P Value ◽

Active Smoking ◽

Directly Observed Therapy ◽

Pulmonary Tb

Active smokers, treatment compliance and sputum smear conversion failed among patients treated for active tuberculosisBackground: One of the infectious diseases that often affects people is pulmonary tuberculosis (pulmonary TB). World data, there are 10.4 million recent cases of tuberculosis or 142 cases / 100,000 populations, with 480,000 cases of failed conversions. Indonesia is a country with the second largest number of recent cases in the world after India. With the success of treatment in Indonesia, it is low at 85%. Data from Lampang Province, the number of new patients with pulmonary tuberculosis is reaching 110 per 100,000 populations. Data in Central Lampung Regency found 954 cases out of 20,184 people suspected (4.73%). Data in Poncowati Public Health Center in Central Lampung in 2018, conversion failure rates were quite high at 16 people out of 42 people with pulmonary TB (38.1% ), and the success of the treatment is also still low, at 76.2% (target> 90%).Purpose: Knowing relation factors active smoker, treatment compliance with failed sputum smear conversion among patients treated for active tuberculosis.Method: A quantitative study with the design by observational analytic. The samples in this study were 42 pulmonary TB patients. Data analysis in this study used the chi-square test.Results: Most respondents smoke <10 cigarettes per day (not at risk), 22 (52.4%). Most respondents obey the ingestion of drugs, which are 28 (66.7%). There was a correlation between active smoking (p-value = 0.002 and OR = 11.762) and medication adherence (p-value = 0.002 and OR = 9,167) with conversion failure in pulmonary tuberculosis patients.Conclusion: There were active smokers, treatment compliance, and sputum smear conversion failed among patients treated for active tuberculosis. It needs to further improve Directly Observed Therapy (DOT) support and the role of health workers in improving patient treatment compliance and motivation in quitting smoking.Keywords : Active smoking; Medication adherence; Conversion failure; Active tuberculosisPendahuluan: Salah satu penyakit menular yang sering diderita masyarakat adalah Tuberculosis paru (TB paru). Data dunia, terdapat 10,4 juta kasus baru tuberkulosis atau 142 kasus/100.000 populasi, dengan 480.000 kasus gagal konversi. Indonesia merupakan negara dengan jumlah kasus baru terbanyak kedua di dunia setelah India. Dengan angka keberhasilan pengobatan di Indonesia rendah, yaitu 85%. Data Provinsi Lampung, jumlah pasien baru tuberculosis paru yaitu mencapai 110 per 100.000 penduduk. Data di Kabupaten Lampung Tengah ditemukan sebanyak 954 kasus dari 20.184 orang suspek (4,73%).Data di Puskesmas Poncowati Lampung Tengah pada tahun 2018, angka kegagalan konversi cukup tinggi yaitu sebanyak 16 orang dari 42 orang penderita TB paru (38,1%), dan keberhasilan pengobatan juga masih rendah, yaitu 76,2% (target >90%). Tujuan: Diketahui hubungan para perokok aktif, kepatuhan menelan obat dan kegagalan konversi (BTA positif) pada pasien tuberculosis.Metode: Jenis penelitian kuantitatif, rancangan penelitian dengan analitik observasional. Sampel sejumlah 42 pasien TB paru. Analisis data pada penelitian ini menggunakan uji chi-square.Hasil: Sebagian besar responden merokok <10 batang perhari (tidak berisiko) yaitu sebanyak 22 orang (52,4%).Sebagian besar responden patuh dalam menelan obat, yaitu sebanyak 28 orang (66,7%). Terdapat hubungan antara merokok aktif (p-value = 0,002 dan OR= 11,762) dan kepatuhan menelan obat (p-value = 0,002 dan OR= 9,167) dengan kegagalan konversi pada pasien tuberculosis.Simpulan: Terdapat hubungan para perokok aktif, kepatuhan menelan obat dan kegagalan konversi (BTA positif) pada pasien tuberculosis. Perlu lebih ditingkatkannya dukungan PMO serta peran petugas kesehatan dalam meningkatkan kepatuhan berobat pasien dan motivasi dalam menghentikan kebiasaan merokok.

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Assessing the Level of Knowledge and Attitude of the Saudi Population in Taif City towards Varicoceles Prevention and Treatment

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i04/1112 ◽

2021 ◽

Vol 6 (04) ◽

pp. 264-268

Author(s):

Dr Khames Alzahrani ◽

Samir Ahmad Badr ◽

Khaled Abdulrahman Almalki ◽

Thamer Eid M Alhathla ◽

Abdulelah Mastour Alotaibi ◽

...

Keyword(s):

Saudi Arabia ◽

General Public ◽

National Level ◽

Survey Study ◽

Categorical Variables ◽

Average Score ◽

P Value ◽

Prevention And Treatment ◽

Level Of Knowledge ◽

Knowledge And Attitude

Background: Varicocele is a common problem in males that drastically affect their reproductive health. There is some way to reduce or prevent this problem from occurrence. However, the level of knowledge of the general public towards these measures is unclear. Methods: A cross-sectional observational survey study that was carried out in Saudi Arabia using an online self-developed questionnaire that was distributed, via a link to Google form, to the general public. All adult literate citizens and residents in Taif city, Saudi Arabia were eligible for inclusion in this study. Only completed surveys were included in the analysis. Data were represented in the form of frequencies (number of responders) and valid percentages for categorical variables. ANOVA test was utilized to compare means between different subgroups. All P values < 0.05 were considered statistically significant. Result: A total of 275 participants responded to the survey. The mean score for knowledge was 10.01±4.305, with a minimum score of zero and a maximum score of eighteen. Females showed a significantly higher mean score (13.67±3.114) (p-value = 0.002). Single participants showed significantly higher mean score (10.26±4.176) (p-value= 0.04). Responders with a university degree had a higher average score (10.35±4.257) (p-value=0.002), and participants with a medical background had a higher average score (11.48±3.401) (p-value<0.001). Conclusion: A poor level of knowledge and attitude towards varicocele prevention and treatment were observed in Saudi Arabia. Further studies are required to figure out the level of knowledge and behaviors on a national level, and to explore the reasons behind this poor knowledge about varicocele.

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The Effect of Family Psychoeducation on Tuberculosis Treatment Adherence of Children in Indonesia

Asian Journal of Medicine and Biomedicine ◽

10.37231/ajmb.2021.5.s2.459 ◽

2022 ◽

Vol 5 (S2) ◽

pp. 44-49

Author(s):

Yuni Kusmiyati ◽

Suherni ◽

Yuliasti Eka Purnamaningrum ◽

Sih Rini Handajani ◽

Agung Jaya Endranto ◽

...

Keyword(s):

Treatment Adherence ◽

Health Workers ◽

Controlled Trial ◽

Primary Caregivers ◽

Control Group ◽

P Value ◽

Family Psychoeducation ◽

Randomized Controlled ◽

Tb Treatment ◽

End Of Treatment

Tuberculosis (TB) is an infectious disease leading cause of death in the world but treatment adherence the most underrated and understudied factor affecting the outcome of TB therapy. The aim of this study was to determine the effect of family psychoeducation on TB treatment adherence of children. The study used a randomized controlled trial (RCT). The sample was 40 pairs of primary caregivers and children who received TB treatment and experienced no side effects of anti-TB drugs in Wonosari Hospital Indonesia in 2019. The treatment group was given psychoeducation by trained health personnel psychoeducators, while the control group was given education by health workers. Psychoeducation was carried out individually, 3 meetings in the first week of the study. Adherence was measured at the sixth month which was the end of treatment period, using a questionnaire. Data were analyzed by using multiple logistic regression. The results showed that family psychoeducation had a significant effect on TB treatment adherence in children after controlling for mother’s knowledge (P-value 0.05 ≤ 0.05). Family psychoeducation is a preventive factor for non-adherence to TB treatment. It is important that psychoeducation is provided to all TB patients to reduce psychological problems that can lead to treatment non-adherence.

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Factors related to the presence of mosquito eggs trapped in ovitraps DHF-endemic areas in Kendari City, Indonesia

Public Health of Indonesia ◽

10.36685/phi.v7i4.445 ◽

2021 ◽

Vol 7 (4) ◽

pp. 159-165

Author(s):

Askrening Askrening ◽

Adi Supryatno ◽

Reni Yunus ◽

Supiati Supiati

Keyword(s):

Environmental Conditions ◽

Significant Relationship ◽

Health Workers ◽

Local Population ◽

Univariate Analysis ◽

Public Health Problem ◽

Bivariate Analysis ◽

P Value ◽

Cross Sectional ◽

Endemic Areas

Background: Dengue hemorrhagic fever (DHF), one type of infectious disease caused by the dengue virus, is still becoming a public health problem in Indonesia. The high number of dengue cases in Indonesia, especially in Kendari City itself, is closely related to environmental conditions, especially when it is known that the city has entered the rainy season.Objective: This study aimed to identify and analyze the factors associated with the presence of mosquito eggs trapped in ovitraps DHF-endemic area in Kendari City, Indonesia.Methods: This study used an analytic observational approach with a cross-sectional design. The research sample in this study was 50 houses located in endemic areas of Kendari selected using simple random sampling. Data were collected by observation using a checklist sheet and direct observation in each room of the respondent's house based on lighting, temperature, humidity, and physical environmental conditions, as well as the presence of mosquito eggs or larvae trapped in the ovitrap. The analysis was carried out in two stages, namely univariate analysis and bivariate analysis using the Chi-Square test.Result: From 50 houses observed, 13 houses (26%) had the presence of mosquito eggs, 42 houses (84%) had bad air temperature, 19 houses (38%) had poor humidity, and 35 houses (70%) had a higher frequency. In addition, the temperature, lighting, and environmental conditions did not have a significant relationship with the presence of mosquito eggs in ovitraps in endemic areas of Kendari City, with p-values of 0.94, 0.52, and 0.39, respectively. In contrast, the humidity factor has a significant relationship with the presence of eggs with a p-value of 0.000.Conclusion: There was a significant relationship between humidity and the presence of mosquito eggs in ovitraps in endemic areas of Kendari City, Indonesia. It is recommended that residents increase Mosquito Nest Eradication (PSN) activities, perform selective abatization, and disseminate information about DHF through counseling or other activities conveyed through health workers with full support from community leaders and adjusted to the level of education of the local population.

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Effect of Smoking on Treatment Outcome Among Tuberculosis Patients in Malaysia; a Multicentre Study

10.21203/rs.2.14862/v3 ◽

2020 ◽

Author(s):

Amer Hayat Khan ◽

Syed Azhar Syed Sulaiman ◽

Mohamed Azmi Hassali ◽

Kashif Ullah Khan ◽

Long Chiau Ming ◽

...

Keyword(s):

Medical Records ◽

Treatment Success ◽

Treatment Interruption ◽

Drug Abusers ◽

Major Barrier ◽

Pulmonary Tb ◽

Patient Demographics ◽

Tb Treatment ◽

Included Patient ◽

Collection Form

Abstract Background: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes.Objectives:To determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients.Methods: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form.Results: Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smoker’s, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with Extra-pulmonary TB. Male gender (OR= 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR= 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR= 0.74, 95% CI 0.58-0.95), urban residents (OR= 1.46, 95% CI 1.33-1.61), employed individuals (OR= 1.21, 95% CI 1.09-1.34), alcoholics (OR= 4.91, 95% CI 4.04-5.96), drug abusers (OR= 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR= 1.27, 95% CI 1.16-1.40) showed significant association with smoking habits. This study found that 3236 (75.0 %) patients were successfully treated in the smoker group, while 4004 (79.7 %) patients were non-smokers. The proportion of death rate 283 (6.6%), defaulters 284 (6.6%) and treatment interruption 204 (4.7%) was high in the smoker's group.Conclusions: Smoking had a strong influence on TB and is a major barrier towards treatment success (OR= 0.76, 95% CI 0.69-0.84, p< 0.001). Therefore, the findings point out that smoking cessations are an effective way to decrease treatment failure and drug resistance.

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Effectiveness of A Community Level Maternal Health Intervention in Improving Uptake of Postnatal Care in Migori County, Kenya

International Journal of Translational Medical Research and Public Health ◽

10.21106/ijtmrph.70 ◽

2019 ◽

Vol 3 (1) ◽

pp. 11-20

Author(s):

Moses M. Gitonga ◽

Kenneth K. Ngure ◽

Elizabeth E. Echoka

Keyword(s):

Maternal Health ◽

Community Health ◽

Health Facility ◽

Community Health Workers ◽

Postnatal Care ◽

Health Workers ◽

Health Intervention ◽

Community Level ◽

Major Barrier ◽

Ex Post

Background: Provision of a continuum of care during pregnancy, delivery, and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Complications and lack of skilled postnatal care has consequences for mothers and babies. We examined to what extent a community level integrated maternal health intervention contributed to improvements in uptake of skilled care after delivery by pregnant women. Methods: An Ex post quasi-experimental design was applied. Among 590 reproductive-aged women, we assessed the effectiveness of a community level integrated maternal health intervention and predictors of uptake of postnatal care. Descriptive, bivariate and multivariate analyses were conducted. Results: About three fifths (64%) of the women reported having sought postnatal care services at the health facility within six (6) weeks. Women in the intervention arm were 3.3 times more likely to take up postnatal care at a health facility (AOR= 3.31[95% CI 1.245 to 8.804] p=0.016). Women referred to the health facility for postnatal care by Community Health Workers (CHWs) were 2.72 times more likely to take up the services (AOR= 2.72[95% CI 1.05 to 7.07] p=0.039) than those not referred by CHWs. Distance to health facility (61%) was the major barrier, while some mothers did not feel the need for postnatal care (11%). Conclusion and Implications for Translation: Routine health education by trained providers at community level health facilities, coupled with enhanced CHWs' involvement can improve uptake of postnatal care. Ignorance and accessibility challenges are some barriers to the uptake of postnatal care. Key words: • Community • Maternal • Health • Intervention • Postnatal-Care • Kenya • MAISHA • Community Health Volunteers (CHVs) • Community Health Workers (CHWs) Copyright © 2019 Gitonga et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Incidence and predictors of lost to follow-up among drug-resistant tuberculosis patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective follow-up study

BMC Infectious Diseases ◽

10.1186/s12879-019-4447-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Getahun Molla Kassa ◽

Alemayehu Shimeka Teferra ◽

Haileab Fekadu Wolde ◽

Atalay Goshu Muluneh ◽

Mehari Woldemariam Merid

Keyword(s):

Public Health Problem ◽

Hazard Ratio ◽

Rank Test ◽

Patient Records ◽

Major Barrier ◽

Follow Up Study ◽

Tb Treatment ◽

Specialized Hospital ◽

Lost To Follow Up

Abstract Background The emergence of Drug-Resistance Tuberculosis (DR-TB) is an increasing global public health problem. Lost to Follow-up (LTFU) from DR-TB treatment remains a major barrier to tuberculosis epidemic control and better treatment outcome. In Ethiopia, evidences on the incidence and predictors of LTFU are scarce. Thus, this study aimed to determine the incidence and identify the predictors of LTFU among DR-TB patients. Methods A retrospective follow-up study was conducted among a total of 332 DR-TB patients at the University of Gondar comprehensive specialized hospital. Data were retrieved from patient records from September 2010 to December 2017 and entered in to Epi-data 4.2.0.0 and analysed using Stata14.1 software. The risk was estimated using the Nelson-Aalen cumulative hazard curve. A log-rank test was used for survival comparisons between categories of independent variables. The Gompertz regression model was fitted, and hazard ratio with a 95% confidence interval (CI) was used to measure the strength of associations. Variables with less than 0.05 p-values in the multivariable model were considered as significantly associated with LTFU. Results Among a total of 332 patient records reviewed, 206 (62.05%) were male. The median age was 30 years (Inter Quartile Range (IQR): 23–40). Forty-one (12.35%) of the participants had no history of TB treatment, while a quarter of were TB-HIV co-infected. Closely all (92.17%) of the patients had pulmonary tuberculosis. The median follow up time was 20.37 months (IQR: 11.02, 21.80). Thirty-six (10.84%) patients were lost from follow-up with an incidence rate of 6.47 (95% CI: 4.67, 8.97)/1000 Person Months (PM). Homelessness (Adjusted Hazard Ratio (AHR) =2.51, 95%CI: 1.15, 5.45) and treatment enrolment year from 2013 to 2014 (AHR = 3.25, 95% CI: 1.30, 8.13) were significant predictors of LTFU. Conclusion This study indicated that LTFU among DR-TB registered patients was high in the first six months compared to subsequent months. Homelessness and year of treatment enrolment were independent predictors of LTFU, requiring more economic support to patients in order to ensure treatment completion. This result can be generalized to patients who are using DR-TB treatment in similar settings.

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