Causes of pre-treatment loss to follow-up in patients with TB.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2022-12-21 DOI:10.5588/pha.22.0051

S Daka, Y Matsuoka, M Ota, S Hirao, A Phiri

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Abstract

Setting: Five urban TB diagnostic centres in Lusaka, Zambia.

Objective: To determine the proportion of bacteriologically confirmed pre-treatment lost to follow-up (LTFU) patients with TB found at the study settings in 2020.

Design: This was a retrospective cohort study in which the TB laboratory and treatment registers at the study sites were cross-matched.

Results: A total of 1,085 bacteriologically confirmed patients with TB were found in the laboratory TB registers at the study settings. Of these, 809 (74.6%) were males, whereas 8 (0.7%) were children, 1,005 (92.6%) were diagnosed using Xpert, 78 (7.2%) by microscopy. A total of 91 (8.4%, 95% CI 6.8-10.2) were determined to be pre-treatment LTFU. Those who had very low (14.0%, 95% CI 8.5-21.2) and low (11.8%, 95% CI 8.4-16.0) results on Xpert were respectively 3.1 (95% CI 1.6-6.0) and 2.6 (95% CI 1.4-4.8) times more likely to become pre-treatment LTFU than those who had medium (4.5%, 95% CI 2.5-7.4) results. The proportions of pre-treatment LTFU varied among the study sites from 0.7% to 16.1%.

Conclusion: Health facilities should strive to account for every patient with TB, with particular attention to those who are bacteriologically confirmed.

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结核病患者治疗前随访损失的原因。

环境:赞比亚卢萨卡的五个城市结核病诊断中心。目的:确定2020年在研究环境中发现的细菌学证实的治疗前失访(LTFU)结核病患者的比例。设计:这是一项回顾性队列研究，研究地点的结核病实验室和治疗登记是交叉匹配的。结果:在研究设置的实验室结核病登记中共发现1,085名细菌学确诊的结核病患者。其中，809例(74.6%)为男性，8例(0.7%)为儿童，1005例(92.6%)为Xpert诊断，78例(7.2%)为显微镜诊断。共有91例(8.4%，95% CI 6.8-10.2)被确定为治疗前LTFU。Xpert结果非常低(14.0%，95% CI 8.5-21.2)和低(11.8%，95% CI 8.4-16.0)的患者成为治疗前LTFU的可能性分别是中度(4.5%，95% CI 2.5-7.4)患者的3.1倍(95% CI 1.6-6.0)和2.6倍(95% CI 1.4-4.8)。处理前LTFU的比例在研究地点从0.7%到16.1%不等。结论:卫生机构应努力对每一位结核病患者作出解释，特别注意那些经细菌学证实的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.