RT Journal Article
SR Electronic
T1 Analysis of loss to follow up in 4,099 multidrug-resistant pulmonary tuberculosis patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1800353
DO 10.1183/13993003.00353-2018
A1 Ian F. Walker
A1 Oumin Shi
A1 Joseph Hicks
A1 Helen Elsey
A1 Xiaolin Wei
A1 Dick Menzies
A1 Zhiyi Lan
A1 Dennis Falzon
A1 Giovanni Battista Migliori
A1 Carlos Pérez-Guzmán
A1 Mario H. Vargas
A1 Lourdes García-García
A1 José Sifuentes Osornio
A1 Alfredo Ponce-De-León
A1 Martie van der Walt
A1 James N. Newell
YR 2019
UL http://erj.ersjournals.com/content/early/2019/04/05/13993003.00353-2018.abstract
AB Loss-to-follow-up (LFU) of two or more consecutive months contributes to the poor levels of treatment success in multidrug-resistant tuberculosis (MDR-TB) reported by TB programmes. We explored the timing of when LFU occurs by month of MDR-TB treatment and identified patient-level risk factors associated with LFU.We analysed a dataset of individual MDR-TB patient data (4099 patients from 22 countries). We used Kaplan-Meier survival curves to plot time to LFU and a Cox proportional hazards model to explore the association of potential risk factors with LFU.One-sixth (n=702) of patients were recorded as LFU. Median time to LFU was 7 months (IQR=3–11). The majority of LFU occurred in the initial phase of treatment (75% in the first 11 months). Major risk factors associated with LFU were: age 36–50 years (Hazard Ratio (HR) 1.3; 95% CI 1.0, 1.6, p=0.04) compared with age 0–25 yrs, being HIV+(HR 1.8; 95% CI 1.2, 2.7, p<0.01) compared with HIV-, on an individualised treatment regimen (HR 0.7; 95% CI 0.6, 1.0, p=0.03) compared with standardised regimen and a recorded serious adverse event (HR 0.5; 95% CI 0.4, 0.6, p<0.01) compared with no serious adverse event.Both patient- and regimen-related factors were associated with LFU which may guide interventions to improve treatment adherence, particularly in the first 11 months.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Mr. Walker reports grants from DFID, UK Government, during the conduct of the study.Conflict of interest: Dr. Shi has nothing to disclose.Conflict of interest: Dr. Hicks has nothing to disclose.Conflict of interest: Dr. Elsey has nothing to disclose.Conflict of interest: Dr. Wei has nothing to disclose.Conflict of interest: Dr. Menzies has nothing to disclose.Conflict of interest: Dr. Lan has nothing to disclose.Conflict of interest: Dr. Falzon has nothing to disclose.Conflict of interest: Dr. Migliori has nothing to disclose.Conflict of interest: Dr. Pérez-Guzmán has nothing to disclose.Conflict of interest: Dr. VARGAS has nothing to disclose.Conflict of interest: Dr. Garcia-Garcia has nothing to disclose.Conflict of interest: Dr. Ponce-De-León has nothing to disclose.Conflict of interest: Dr. van der Walt has nothing to disclose.Conflict of interest: Dr. Newell has nothing to disclose.Conflict of interest: Dr. Osornio has nothing to disclose.