Default Time from Tuberculosis Treatment in the Southern Republic of Benin Using Mixture Cure Model for Survival Analysis

Tchibozo, Anicet

doi:10.15406/bbij.2015.02.00039

Cited by 5 publications

(9 citation statements)

References 40 publications

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“…In this study, TB patients with older age experienced loss to follow-up when compared to TB patients in younger age. This finding is consistent with a finding from Benin [38]. This could be plausible as this category of patients requests more social support from their communities.…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, the HIV non-reactive patients had much reduction in risk of loss to follow-up and improved survival time compared to those who were reactive for HIV, and the difference was statistically significant. This finding is consistent with other similar studies in that co-infected patients were more likely to loss to follow-up TB treatment relative to those whose HIV sero status was negative [38,39]. Encouragingly, in TB-HIV co-infected patients, the receipt of ART was found to be protective against treatment loss to follow-up [40][41][42].…”

Section: Discussionsupporting

confidence: 90%

“…This could confirm the fact that TB is the most common opportunistic disease and the most common cause of burden in patients with HIV/AIDS infection in developing countries. But the mechanism by which the co-infection induces loss to follow-up from anti-TB treatment remains unclear [38].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the duration of treatment, which is 6 to 8 months, is long in terms of separation from patients' home towns and daily habits. Therefore, programs of DOTS at home or inside the community of origin could be a better TB surveillance strategy for the elder TB patients [38].…”

Section: Discussionmentioning

confidence: 99%

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Does time to loss to follow-up differ among adult tuberculosis patients initiated on tuberculosis treatment and care between general hospital and health centers? A retrospective cohort study

2020

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Background: Patients' loss to follow-up (LTFU) from tuberculosis treatment and care is a growing worry in Ethiopia. But, available information is inadequate in assessing the time to tuberculosis patient loss to follow-up difference between health centers and a general hospital in Ethiopia. We aimed to assess time to LTFU difference between health centers and a general hospital in rural Ethiopia. Methods:We conducted a retrospective cohort study from September 2008 to August 2015 and collected data from September 1 to October 02, 2016. A total of 1341 TB patients with known treatment outcomes were included into the study. Log rank test was used to compare the difference in time to TB patient loss to follow-up between health centers and a general hospital, whereas Cox proportional hazard model was used to assess factors associated with time to loss to follow-up in both settings. Results: We reviewed a total of 1341 patient records, and the overall follow-up time was 3074.7 and 3974 person months of observation (PMOs) for TB patients followed at health centers and a general hospital, respectively. The incidence of loss to follow-up rate was 27.3 per 1000 PMOs and 9.6 per 1000 PMOs, at health centers and a general hospital, respectively. From the overall loss to follow-ups that occurred, 55 (65.5%) and 33 (86.8%) of LTFUs occurred during the intensive phase and grew to 78 (92.9%) and 38 (100%) at health center and a general hospital, respectively, at the end of 6-month observation period. Older age (AOR = 1.7, 95%CI, 1.2-2.5, P < 0.001), being a rural resident (AHR = 2.7, 95%CI, 1.6-4.6), HIV reactive (AHR = 2.2, 95%CI, 1.5-3.2), following treatment and care in health center (AHR = 3.38, 95%CI, 2.06-5.53), and living at more than 10 km away from the health facility (AHR = 3.4, 95%CI, 2.1-5.7) were predictors for time to loss to follow-up among TB patients on treatment and care. Conclusion: Time to TB patient loss to follow-up between health centers and a general hospital was significant. Loss to follow-up was high in patients with older age, rural residence, sero positive for HIV, living further from the health facilities, and following treatment and care at health centers. Strengthening the DOTs program with special emphasis on health centers is highly recommended.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Does time to loss to follow-up differ among adult tuberculosis patients initiated on tuberculosis treatment and care between general hospital and health centers? A retrospective cohort study

2020

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“…A significant proportion of patients stop treatment before completion for various reasons. While the drug supply chain plays a major role, 11 gender, alcoholism, treatment after default, HVI/ AIDS, socioeconomic status, the stigma of the disease, the lack of information, dissatisfaction with the treatment and its delivery, and inaccessibility of treatment 17,[26][27][28][29][30][31][32][33][34][35] were found as predicting the treatment interruption. The standard anti-tuberculosis therapy consists of a cocktail of drugs taken over a period of at least 6 months for new patients and 8 months for patients under retreatment.…”

Section: Risk Factorsmentioning

confidence: 99%

Untitled

2015

BBIJ

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Background: To date, this is the first statistical analysis of default time from tuberculosis (TB) treatment conducted in the republic of Benin. This cohort study assessed the cured fraction, the conditional probability of default (CPD) from treatment course and identified the risk factors predicting its timing. Methods: TB case was a patient with positive culture for the Mycobacterium tuberculosis complex or with two sputum smears positive for acid-fast bacilli. The 2008's cohort of TB patients was extracted from Benin national TB registry. Active TB Patients who were diagnosed between November 2007 and December 2008 were included and followed up to December, 23 rd 2009 relative to their specific initiation date. Default was defined using the WHO guidelines. Primary endpoint was the time to default from the anti-TB treatment course. Risk factors were assessed with univariate and multivariate Cox regression integrating the mixture cure models. Results: More than 5% (n=64) of defaulters were identified with a cured fraction of 94.1%. About 3% of patients defaulted within the first 2 months (CPD = 0.025 ± 0.004). HIV/AIDS co-infection and TB history were independently associated with default time (log-rank = 35.21; P < 0.0001 and log-rank = 10.11; P = 0.0015 respectively). With Cox proportional hazards (PH) analysis, predictors of default time were HIV/AIDS, TB history and Age (hazard ratio [HR] = 3.82 [2.28; 6.41], P < 0.0001 for HIV-positive, HR = 0.13 [0.03; 0.53], P = 0.0045 for previous-TB infection and Age (HR = 3.49 [1.25; 9.74], P = 0.0170 for 65 years old or more, respectively). With logistic Cox PH mixture cure model HIV/AIDS and Age significantly increased the probability of default (Odds Ratios [OR] = 4.04 [2.64; 7.08], P < 0.0001 for HIV-positive, and OR = 4.23 [1.58; 12.10], P = 0.006 for 65 years old or more, respectively) whereas TB history significantly reduced default probability (OR = 0.04 [0.004; 0.54], P = 0.0148 for previous-TB infection. Conclusion: Whatever the alternative model considered, this study provides the first evidence that HIV/AID, TB history and Age were the major predictive factors of default time from anti-TB treatment in Benin. Therefore, additional efforts to improve the compliance of patients with anti-TB treatment through a better management of the co-infection with HIV/AIDS in accordance with patient's specific age group may be an important feature of a prospective TB control strategy in the future. This should be emphasized in the early treatment course for these subgroups of TB patients.

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Risk factors for early TB treatment interruption among newly diagnosed patients in Malaysia

Suliman

Lim

Said

et al. 2022

Sci Rep

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TB treatment interruption has resulted in delayed sputum conversion, drug resistance, and a high mortality rate and a prolonged treatment course, hence leading to economic and psychosocial affliction. To date, there are limited studies investigating the physico-social risk factors for early treatment interruptions. This prospective multicenter cohort study aimed to investigate the risk factors for early treatment interruption among new pulmonary tuberculosis (TB) smear-positive patients in Selangor, Malaysia. A total of 439 participants were recruited from 39 public treatment centres, 2018–2019. Multivariate Cox proportional hazard analyses were performed to analyse the risk factors for early treatment interruption. Of 439 participants, 104 (23.7%) had early treatment interruption, with 67.3% of early treatment interruption occurring in the first month of treatment. Being a current smoker and having a history of hospitalization, internalized stigma, low TB symptoms score, and waiting time spent at Directly Observed Treatment, Short-course centre were risk factors for early treatment interruption. An appropriate treatment adherence strategy is suggested to prioritize the high-risk group with high early treatment interruption. Efforts to quit smoking cessation programs and to promote stigma reduction interventions are crucial to reduce the probability of early treatment interruption.

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Default Time from Tuberculosis Treatment in the Southern Republic of Benin Using Mixture Cure Model for Survival Analysis

Cited by 5 publications

References 40 publications

Does time to loss to follow-up differ among adult tuberculosis patients initiated on tuberculosis treatment and care between general hospital and health centers? A retrospective cohort study

Does time to loss to follow-up differ among adult tuberculosis patients initiated on tuberculosis treatment and care between general hospital and health centers? A retrospective cohort study

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Risk factors for early TB treatment interruption among newly diagnosed patients in Malaysia

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