Multidrug-resistant tuberculosis patients' views of interventions to reduce treatment loss to follow-up

Tupasi, Thelma E.; Garfin, Anna Marie Celina; Mangan, Joan M.; Orillaza-Chi, R.; Naval, L. C.; Balane, G. I.; Basilio, Ramon P.; Golubkov, Alexander; Joson, E. S.; Lew, Woo Jin; Lofranco, Vivian; Mantala, Mariquita; Pancho, S.; Sarol, Jesus N.; Blumberg, A; Burt, David R.; Kurbatova, Ekaterina V.

doi:10.5588/ijtld.16.0433

Cited by 12 publications

(16 citation statements)

References 22 publications

(15 reference statements)

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“…These are unfortunately features of many national health systems in LMICs, creating a troubling context for reforms towards personcentredness [125]. Importantly, many challenges faced by TB patients lie outside the formal health system spheretransport problems, medication reactions and food assistance [126]. A particular silence in current literature relates to occupational dimensions of TB, both prevention and treatment and care.…”

Section: Discussionmentioning

confidence: 99%

Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

et al. 2020

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Background: There is increasing evidence that the substantial global burden of disease for tuberculosis unfolds in concert with dimensions of common mental disorders. Person-centred care holds much promise to ameliorate these comorbidities in low-to-middle income countries (LMICs) and emerging economies. Towards this end, this paper aims to review 1) the nature and extent of tuberculosis and common mental disorder comorbidity and 2) person-centred tuberculosis care in low-to-middle income countries and emerging economies. Main text: A scoping review of 100 articles was conducted of English-language studies published from 2000 to 2019 in peer-reviewed and grey literature, using established guidelines, for each of the study objectives. Four broad tuberculosis/ mental disorder comorbidities were described in the literature, namely alcohol use and tuberculosis, depression and tuberculosis, anxiety and tuberculosis, and general mental health and tuberculosis. Rates of comorbidity varied widely across countries for depression, anxiety, alcohol use and general mental health. Alcohol use and tuberculosis were significantly related, especially in the context of poverty. The initial tuberculosis diagnostic episode had substantial sociopsychological effects on service users. While men tended to report higher rates of alcohol use and treatment default, women in general had worse mental health outcomes. Older age and a history of mental illness were also associated with pronounced tuberculosis and mental disorder comorbidity. Person-centred tuberculosis care interventions were almost absent, with only one study from Nepal identified. Conclusions: There is an emerging body of evidence describing the nature and extent of tuberculosis and mental disorders comorbidity in low-to-middle income countries. Despite the potential of person-centred interventions, evidence is limited. This review highlights a pronounced need to address psychosocial comorbidities with tuberculosis in LMICs, where models of person-centred tuberculosis care in routine care platforms may yield promising outcomes.

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Section: Discussionmentioning

confidence: 99%

Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

et al. 2020

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“…Despite the provision of individualized socioeconomic support to all patients by the national Programmatic Management of Drug-resistant Tuberculosis (PMDT) program, LTFU among homeless patients was high. This might be explained by the fact that homelessness is extremely linked to poverty that triggers the risk for LTFU [29]. Another reason could be the difficulty of tracing such patients when they interrupt treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it can also be explained in that majority (67.47%) of our patients were in the age of thirties who might be responsible to support their families that could trigger to lost from follow-up. The relationship between financial constraints, adequate nutrition, and the fear of losing jobs were challenges to patients who need to complete treatments as evidenced by different studies [14, 29]. Therefore, the disparity between working hours and treatment center schedules as well as inability to work due to treatment side effects might be the possible reasons for the higher hazard of LTFU among homeless patients.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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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“…It is proven by the improvement on treatment regularity when TB treatment is given for free. Treatment regularity is believed and expected to reduce the incidences of resistance to TB medications (Eastment et al, 2017;Tupasi et al, 2017;Zhang et al, 2015). Shringarpure et al (2016) mentioned that geographic location also influence patients' adherence in TB treatment.…”

Section: The Association Between Perceivedmentioning

confidence: 99%

Health Belief Model and PRECEDE PROCEED on the Risk Factors of Multidrug Resistant Tuberculosis in Surakarta, Central Java

Vera

Rahardjo

Murti

2017

J EPIDEMIOL PUBLIC HEALTH

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Background: Tuberculosis (TB) is one of the lethal infectious diseases in the world. One of the current biggest challenges of Tuberculosis control is the widespread emergence of Multidrug Resistant Tuberculosis (MDR-TB). There are several potential risk factors of MDR-TB that can be explained by Health Belief Model and PRECEDE PROCEED model framework. This study aimed to analyzed factors associated with MDR-TB using Health Belief Model and PRECEDE PROCEED. Subjects and Method:This was an analytic observational study with case control design. The study was conducted at Dr. Moewardi Hospital and BBKPM, Surakarta, from September to November 2017. The study subjects were selected using fixed disease sampling, consisting of 76 MDR-TB patients and 228 TB patients. The dependent variable was MDR-TB. The independent variables were educational level, self-efficacy, drug-taking adherence, smoking, nutritional status, perceived of susceptibility, perceived barrier, perceived severity, perceived benefit, and drug-taking supervisor. The data were collected using questionnaire and analyzed by path analysis. Results: The risk of MDR-TB was increased by lack of drug-taking adherence (b= -1.69; 95% CI= -2.28 to -1.09; p <0.001), poor nutritional status (b= 1.32; 95% CI= 0.72 to 1.92; p<0.001), and smoking (b= 1.32; 95% CI= 0.72 to 1.92; p <0.001). Drug-taking adherence was increased by perceived susceptibility (b= 0.91; 95% CI= 0.18 to 1.63; p=0.015), perceived severity (b= 1.01; 95% CI= 0.28 to 1.74; p=0.007), perceived benefit (b= 1.69; 95% CI= 0.97 to 2.41; p<0.001), drugtaking advisor (b= 2.16; 95% CI= 1.44 to 2.88; p<0.001), self efficacy (b= 1.58; 95% CI= 0.86 to 2.31; p<0.001), and low perceived barrier (b= -1.10; 95% CI= -1.82 to -0.38; p=0.003). Conclusion:The risk of MDR-TB is increased by the lack of drug-taking adherence, poor nutritional status, and smoking.

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Multidrug-resistant tuberculosis patients' views of interventions to reduce treatment loss to follow-up

Cited by 12 publications

References 22 publications

Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

Comorbidities between tuberculosis and common mental disorders: a scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

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

Health Belief Model and PRECEDE PROCEED on the Risk Factors of Multidrug Resistant Tuberculosis in Surakarta, Central Java

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