Risk factors associated with loss to follow-up from tuberculosis treatment in Tajikistan: a case-control study

BMC Infectious Diseases

Research Article

Mavluda Makhmudova¹  Firuza Saidova¹  Suzanne Verver²  Jessica Wohlleben³  Christina Mergenthaler⁴  Shahnoza Azamova⁵ 

[1] KNCV TB Foundation, country office Tajikistan, Dushanbe, Tajikistan;KNCV Tuberculosis Foundation, Evidence team, The Hague, The Netherlands;Academic Medical Centre, AIGHD, Amsterdam, the Netherlands;Present address: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands;KNCV Tuberculosis Foundation, Evidence team, The Hague, The Netherlands;Department of International Health, University Maastricht, Maastricht, The Netherlands;KNCV Tuberculosis Foundation, Evidence team, The Hague, The Netherlands;Present address: Royal Tropical Institute (KIT), Amsterdam, The Netherlands;Republican Center for protection of population from TB, Dushanbe, Tajikistan;

关键词: Default;    Migration;    Case-control study;   

DOI  :  10.1186/s12879-017-2655-7

 received in 2016-11-05, accepted in 2017-07-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThere are very few studies on reasons for loss to follow-up from TB treatment in Central Asia. This study assessed risk factors for LTFU and compared their occurrence with successfully treated (ST) patients in Tajikistan.MethodsThis study took place in all TB facilities in the 19 districts with at least 5 TB patients registered as loss to follow-up (LTFU) from treatment. With a matched case control design we included all LTFU patients registered in the selected districts in 2011 and 2012 as cases, with ST patients from the same districts being controls. Data were copied from patient records and registers. Conditional logistic regressions were run to analyse associations between collected variables and LTFU as dependent variable.ResultsThree hundred cases were compared to 592 controls. Half of the cases had migrated or moved. In multivariate analysis, risk factors associated with increased LTFU were migration to another country (OR 10.6, 95% CI 6.12–18.4), moving within country (OR 11.0, 95% CI 3.50–34.9), having side effects of treatment (OR 3.67, 95% CI 1.68–8.00) and being previously treated for TB (OR 2.03, 95% CI 1.05–3.93). Medical staff also mentioned patient refusal, stigma and family problems as risk factors.ConclusionsLTFU of TB patients in Tajikistan is largely a result of migration, and to a lesser extent associated with side-effects and previous treatment. There is a need to strengthen referral between health facilities within Tajikistan and with neighbouring countries and support patients with side effects and/or previous TB to prevent loss to follow-up from treatment.

【 授权许可】

CC BY   
© The Author(s). 2017