Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study
Despite having universal access to tuberculosis (TB) treatment, loss to follow-up (LFU) rates remain high in Georgia, 6% among drug-susceptible TB (DS-TB) patients (2017 cohort) and 19% among drug-resistant TB (DR-TB) patients diagnosed in 2016. A cohort study was conducted to analyze secondary data...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2021-01-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://monaldi-archives.org/index.php/macd/article/view/1705 |
| _version_ | 1818394201185845248 |
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| author | Natalia Adamashvili Kristina Akopyan Nestani Tukvadze Kostyantyn Dumchev Yuliia Sereda Irma Khonelidze Giorgi Kuchukhidze |
| author_facet | Natalia Adamashvili Kristina Akopyan Nestani Tukvadze Kostyantyn Dumchev Yuliia Sereda Irma Khonelidze Giorgi Kuchukhidze |
| author_sort | Natalia Adamashvili |
| collection | DOAJ |
| description | Despite having universal access to tuberculosis (TB) treatment, loss to follow-up (LFU) rates remain high in Georgia, 6% among drug-susceptible TB (DS-TB) patients (2017 cohort) and 19% among drug-resistant TB (DR-TB) patients diagnosed in 2016. A cohort study was conducted to analyze secondary data from the Georgian National Tuberculosis Surveillance Database. Study population included adult (≥18 y.o.) patients with bacteriologically confirmed pulmonary TB who were enrolled in Georgian National TB program during 2015-2017. The outcome of interest was loss to follow-up, defined as treatment interruption for more than 2 consecutive months. Patients were stratified by treatment profile (first-line drugs or second-line drugs) and survival analysis was performed within the stratified groups. A total of 7860 treatment episodes were identified during 2015-2017 which corresponded to 6696 bacteriologically confirmed pulmonary TB treatment episodes of whom 795 (12%) were LFU. After adjustment, final multivariate analysis showed that male sex (aHR 1.5, 95%CI 1.2-2.0), being diagnosed in Tbilisi (aHR 1.3, 95%CI 1.1-1.6), unemployment at the time of diagnosis (aHR 1.7, 95%Ci 1.2-2.3) and previous history of TB treatment were independent risk factors for LFU (aHR 2.3, 95%CI 1.9-2.8) among patients on first-line drugs. Among patients on second-line drugs being male (aHR 2.0, 95%CI 1.2-3.2), past TB treatment with second-line drugs (aHR 2.2, 95%CI 1.5-3.2) were significantly associated with LFU. LFU rate was high among patients on first-line drugs and second line drugs (10% and 22% respectively). Patients with past TB treatment history should further research to identify factors that lead to treatment interruption in this group. Other factors associated with LFU (being internally displaced person (IDP), being unemployed, and having imprisonment history) were in some level indication of a poor social-economic status, and strengthening approaches for TB care based on patients’ need could be considered in light of this finding. |
| first_indexed | 2024-12-14T05:57:26Z |
| format | Article |
| id | doaj.art-be4b8600fd5f4f1ca4c82d2730296aca |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-12-14T05:57:26Z |
| publishDate | 2021-01-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-be4b8600fd5f4f1ca4c82d2730296aca2022-12-21T23:14:31ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642021-01-0191110.4081/monaldi.2021.1705Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort studyNatalia Adamashvili0Kristina Akopyan1Nestani Tukvadze2Kostyantyn Dumchev3Yuliia Sereda4Irma Khonelidze5Giorgi Kuchukhidze6National Center for Disease Control and Public Health, TbilisiTuberculosis Research and Prevention Center NGO, YerevanNational Center for Tuberculosis and Lung Diseases, TbilisiUkrainian Institute of Public Health Policy, KyivWorld Health Organization, Regional Office for Europe, CopenhagenNational Center for Disease Control and Public Health, TbilisiWorld Health Organization, Regional Office for Europe, CopenhagenDespite having universal access to tuberculosis (TB) treatment, loss to follow-up (LFU) rates remain high in Georgia, 6% among drug-susceptible TB (DS-TB) patients (2017 cohort) and 19% among drug-resistant TB (DR-TB) patients diagnosed in 2016. A cohort study was conducted to analyze secondary data from the Georgian National Tuberculosis Surveillance Database. Study population included adult (≥18 y.o.) patients with bacteriologically confirmed pulmonary TB who were enrolled in Georgian National TB program during 2015-2017. The outcome of interest was loss to follow-up, defined as treatment interruption for more than 2 consecutive months. Patients were stratified by treatment profile (first-line drugs or second-line drugs) and survival analysis was performed within the stratified groups. A total of 7860 treatment episodes were identified during 2015-2017 which corresponded to 6696 bacteriologically confirmed pulmonary TB treatment episodes of whom 795 (12%) were LFU. After adjustment, final multivariate analysis showed that male sex (aHR 1.5, 95%CI 1.2-2.0), being diagnosed in Tbilisi (aHR 1.3, 95%CI 1.1-1.6), unemployment at the time of diagnosis (aHR 1.7, 95%Ci 1.2-2.3) and previous history of TB treatment were independent risk factors for LFU (aHR 2.3, 95%CI 1.9-2.8) among patients on first-line drugs. Among patients on second-line drugs being male (aHR 2.0, 95%CI 1.2-3.2), past TB treatment with second-line drugs (aHR 2.2, 95%CI 1.5-3.2) were significantly associated with LFU. LFU rate was high among patients on first-line drugs and second line drugs (10% and 22% respectively). Patients with past TB treatment history should further research to identify factors that lead to treatment interruption in this group. Other factors associated with LFU (being internally displaced person (IDP), being unemployed, and having imprisonment history) were in some level indication of a poor social-economic status, and strengthening approaches for TB care based on patients’ need could be considered in light of this finding.https://monaldi-archives.org/index.php/macd/article/view/1705Tuberculosispulmonary tuberculosisloss to follow-up |
| spellingShingle | Natalia Adamashvili Kristina Akopyan Nestani Tukvadze Kostyantyn Dumchev Yuliia Sereda Irma Khonelidze Giorgi Kuchukhidze Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study Monaldi Archives for Chest Disease Tuberculosis pulmonary tuberculosis loss to follow-up |
| title | Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study |
| title_full | Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study |
| title_fullStr | Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study |
| title_full_unstemmed | Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study |
| title_short | Factors associated with loss to follow-up among people with tuberculosis in the country of Georgia: a cohort study |
| title_sort | factors associated with loss to follow up among people with tuberculosis in the country of georgia a cohort study |
| topic | Tuberculosis pulmonary tuberculosis loss to follow-up |
| url | https://monaldi-archives.org/index.php/macd/article/view/1705 |
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