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

Abstract

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.

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

“…Consequently, about 92% of public hospitals and health centers in Ethiopia provide DOTS [15]. Loss to follow-up of TB patients is troubled with problems, primarily because of MDR-TB [16][17][18]. Non-adherence to complete treatment poses a substantial public health menace through disease recurrence, amplified transmission, and development of drug resistance [19,20].…”

Predictors of loss to follow-up of tuberculosis cases under the DOTS programme in Namibia

“…Nevertheless, the gradual rise in incidence of drug-resistant TB (DR-TB) and poor treatment outcomes such as "lost-to-follow-up" (LTFU) (i.e. an interruption of TB treatment for at least two consecutive months) and death [7][8][9][10] are major barriers to ending TB in Namibia [3,[11][12][13][14]. For instance, the incidence of LTFU among notified cases in Namibia increased from 4% in 2014 to 10% in 2015.…”

Survival Status and Predictors of Loss to Follow-up Among Adult Patients with Tuberculosis on Follow-up and Care in Public Health Facilities of Sheka Zone, South-West Ethiopia: Facility-Based, Retrospective Cohort Study

“…Although effective treatment is available for years, tuberculosis (TB) is still a foremost global health problem (1). By 2016, about 10.4 million novel cases and 1.5 million life losses were attributable to TB (1,2).…”

“…Although effective treatment is available for years, tuberculosis (TB) is still a foremost global health problem (1). By 2016, about 10.4 million novel cases and 1.5 million life losses were attributable to TB (1,2). Despite being the home for around 25% of universally registered cases of TB, sub-Saharan Africa carries a much exceeding share of TB related deaths (40%), TB/HIV co-infections (72%), and TB/HIV deaths (80%); and relatively lowered coverage and worth of TB prevention, care, and treatment programs in Africa are among the many reasons for it (3).…”

“…Developing countries have a share of 95% of cases and 99% of deaths (4). Ethiopia with 22 high TB burden countries, accounts for nearly 80% of all worldwide TB load and is ranked the 10th globally and the 4th in Africa (1,2,5). There were an estimated 30000 mortalities per year and higher than 80 TB-related deaths daily, excluding HIV-related deaths in Ethiopia during the same period (6,7).…”