Abstract
BackgroundWe characterise the loss to follow-up (locally termed abandoned) of tuberculosis treatment with individual and ecological health determinants and to identify the predictive capacity of these risk factors. MethodsA cohort study with individual and ecological characterisation of patients diagnosed with tuberculosis in Sergipe/Brazil from 2015 to 2018 with either loss to follow-up or completion of treatment as a therapeutic outcome was performed. The examined variables were based on the social determinants of health with descriptive analysis, binary logistic regression, a generalised hierarchical model and graphical presentation using a nomogram. ResultsThe loss to follow-up accounted for 18.21% of the 2,449 studied cases. The characteristics revealed that the highest abandonment percentages were people who: were male (20.0%), had black skin colour (20.3%), were aged 20–39 years (21.8%), had 4–7 years of schooling (23.6%), re-entered treatment after abandonment (36.5%), used alcohol (31.0%), used drugs (39.3%), were smokers (26.5%) and were homeless (55.4%). The ecological characteristics showed that individuals living in municipalities with a high human development index (HDI; odds ratio [OR]: 1.91) and high-income inequality (OR: 1.81) had a greater chance of not finishing the treatment. Most of these variables were identified as predictors in the generalised hierarchical model; the receiver operating characteristic curve (ROC) curve had 0.771 precision and 84.0% accuracy. ConclusionThe group of identified characteristics influenced the loss to follow-up of tuberculosis treatment. This data provides evidence for the early identification of individuals who are at greater risk of abandoning tuberculosis treatment.
Highlights
Tuberculosis (TB) has a worldwide impact on public health, since it is the infectious disease that kills the most people globally [1] and is an epidemic still neglected [2] and not solved in the 21st century
We identified that individuals living in a municipality with a high human development index (HDI) were 1.91 times more likely to not finish TB treatment when compared to municipalities with a lower HDI
This study identified individual and ecological risk factors for abandoning TB treatment in patients in Sergipe, Brazil
Summary
Tuberculosis (TB) has a worldwide impact on public health, since it is the infectious disease that kills the most people globally [1] and is an epidemic still neglected [2] and not solved in the 21st century. Out of the 30 priority countries for TB control actions, only nine achieved a 90% treatment success rate Countries such as Angola, Brazil, the Central African Republic, Liberia and Papua New Guinea showed greater than 10% loss following treatment [1, 3]. The ecological characteristics showed that individuals living in municipalities with a high human development index (HDI; odds ratio [OR]: 1.91) and high-income inequality (OR: 1.81) had a greater chance of not finishing the treatment Most of these variables were identified as predictors in the generalised hierarchical model; the receiver operating characteristic curve (ROC) curve had 0.771 precision and 84.0% accuracy. Conclusion: The group of identified characteristics influenced the loss to follow-up of tuberculosis treatment This data provides evidence for the early identification of individuals who are at greater risk of abandoning tuberculosis treatment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
