Pre-treatment loss to follow-up in tuberculosis patients in low- and lower-middle-income countries and high-burden countries: a systematic review and meta-analysis

MacPherson, Peter; Houben, Rein M. G. J.; Glynn, Judith R.; Corbett, Elizabeth L.; Kranzer, Katharina

doi:10.2471/blt.13.124800

Cited by 187 publications

(199 citation statements)

References 28 publications

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“…A similar rate of LTFU among TB patients was documented in study done in Kenya [16], in which 146 (13%) of 1094 TB registered patients were lost to follow-up treatment. A systematic review and meta-analysis by MacPherson and colleagues found that pretreatment loss to follow-up was high, from 4 to 38%, and was higher in sub-Saharan Africa (18%) than in Asia (13%), which is consistent with the result of the current study [17]. Studies in other regions of the globe indicate slightly higher rates: in Georgia 29% of all patients initiating treatment for multi-drug-resistant TB were lost to follow-up during treatment [18].…”

Section: Discussionsupporting

confidence: 82%

Survival Analysis of Loss to Follow-Up Treatment among Tuberculosis Patients at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia

Akessa

Tadesse

Abebe

2015

International Journal of Statistical Mechanics

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Background. Tuberculosis (TB) patients who do not complete treatment pose a potential public health risk through disease reactivation, increased transmission, and development of drug-resistance. This study is aimed at analyzing the time to loss to followup treatment and risk factors among TB patients. Methods. This was a retrospective cohort study based on record review of 510 TB patients enrolled in Jimma University Specialized Hospital. The Cox's proportional hazard model and Kaplan-Meier curves were used to model the outcome of interest. Loss to follow-up was used as an outcome measure. Results. Out of 510 TB patients, 69 (13.5%) were lost to follow-up (LTFU) treatment. The median times of survival starting from the date of treatment initiation were 5.7 months. The majority of LTFU patients interrupted treatment during continuation phase. Treatment LTFU has an association with HIV status, weight, and residence. However, living in the rural area has a cause for LTFU patients on multivariate analysis (HR 4.4,. Conclusions. High rate of LTFU was observed among TB patients in Southwest Ethiopia. Treatment LTFU was more frequently observed among patients who came from rural areas. This underlines the need for distributing TB treatment to the rural area.

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Section: Discussionsupporting

confidence: 82%

Survival Analysis of Loss to Follow-Up Treatment among Tuberculosis Patients at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia

Akessa

Tadesse

Abebe

2015

International Journal of Statistical Mechanics

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“…34,35 This requires improved linkages between diagnosis and treatment. 36 Importantly, studies indicate that the expansion of improved diagnostics and treatment in combination with other prevention interventions, such as an improved vaccine and programmatic management of HIV co-infection and MDR-TB, leads to the largest reduction in the burden of disease. 37 …”

Section: Ending Tuberculosis Transmissionmentioning

confidence: 99%

Ending tuberculosis by 2030: can we do it?

Suthar¹,

Zachariah²,

Harries³

2016

int j tuberc lung dis

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“…However, this finding is consistent with previous findings of loss to care in the TB care cascade. 36 Significant barriers to care include transportation costs, stigma and increased burden due to concomitant TB therapy and ART. [37][38][39] We suggest that TB control strategies should integrate strategies to eliminate gaps in the spectrum of care.…”

Section: Programmatic Challengesmentioning

confidence: 99%

Policy to practice: impact of GeneXpert MTB/RIF implementation on the TB spectrum of care in Lilongwe, Malawi

Chawla¹,

Kanyama²,

Mbewe³

et al. 2016

Trans R Soc Trop Med Hyg

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Background: While previous research has provided evidence of the diagnostic accuracy of the GeneXpert MTB/ RIF (GeneXpert), further information is needed about implementation in the real-world. This study evaluated the impact of the introduction of GeneXpert testing in a tertiary medical center according to the testing algorithm proposed by the National TB Control Program (NTP) guidelines.Methods: All adult medical inpatient persons with presumptive TB admitted between November 2013 and March 2014 were eligible for GeneXpert sputum testing and followed to TB treatment initiation status.Results: We identified 932 persons with presumptive TB, of which 307 (32.9%) were GeneXpert tested. Those tested had an average age of 40 years, 49.2% (151) were male, 34.5% (106) were HIV positive, and 84.1% (249) presented with a cough. Of those GeneXpert tested, 28/307 (9.1%) tested positive, a 55.5% increase in detection compared to smear microscopy. However, the majority (44/72, 61%) of TB diagnoses were made by other modalities and not confirmed microbiologically. Of the 58 patients recommended to start treatment and discharged from the hospital, only 23 (40%) were documented to have started treatment at regional directly observed treatment, short course (DOTS) centers.Conclusions: GeneXpert contributed minimally to overall TB diagnosis and the cascade of care due to implementation challenges of sputum collection, empiric treatment, and weak linkage to care between inpatient and outpatient settings.

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Pre-treatment loss to follow-up in tuberculosis patients in low- and lower-middle-income countries and high-burden countries: a systematic review and meta-analysis

Cited by 187 publications

References 28 publications

Survival Analysis of Loss to Follow-Up Treatment among Tuberculosis Patients at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia

Survival Analysis of Loss to Follow-Up Treatment among Tuberculosis Patients at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia

Ending tuberculosis by 2030: can we do it?

Policy to practice: impact of GeneXpert MTB/RIF implementation on the TB spectrum of care in Lilongwe, Malawi

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