Early identification of individuals at risk for loss to follow-up of tuberculosis treatment: A generalised hierarchical analysis. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Lima, Shirley Verônica Melo Almeida; de Araújo, Karina Conceição Gomes Machado; Nunes, Marco Antonio Prado; Nunes, Carla
• Is Part Of: Heliyon. Volume 7:Issue 4(2021)
• Publication Date: 2021-04
• Subjects: Tuberculosis -- Therapy -- Risk factors -- Social determinants of health -- Epidemiology; Research -- Periodicals; Medical sciences -- Periodicals; Natural history -- Periodicals; Social sciences -- Periodicals; Earth sciences -- Periodicals; Physical sciences -- Periodicals; 507.2
• DOI: 10.1016/j.heliyon.2021.e06788
• Languages: English
• ISSNs: 2405-8440

Abstract

Abstract: Background: We 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. Methods: A 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. Results: The 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. 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. Abstract : Tuberculosis. Therapy. Risk factors. Social Determinants of Health. Epidemiology.