Determinant Factors for Loss to Follow-Up in Drug-Resistant Tuberculosis Patients: The Importance of Psycho-Social and Economic Aspects
Abstract Background: Drug-resistant TB (DR-TB) is the barrier for global TB elimination efforts with a lower treatment success rate. Loss to follow-up in DR-TB is a serious problem caused mortality and morbidity for patients and leads to wide spreading of DR-TB to their family and the wider community, as well as wasting health resources. Prevention and management loss to follow-up is crucial to reduce mortality, prevent further spread of DR-TB, and inhibit the development and transmission of more extensively drug-resistant strains of bacteria. Study about the factors associated with loss to follow-up is needed to develop appropriate strategies to prevent DR-TB patients become loss to follow-up. This study was conducted to identify the risk factors correlated with loss to follow-up in DR-TB patients, using questionnaires in the point of view from patients.Methods: An observational study with cross-sectional design was conducted. Study subjects were all DR-TB patients who have declared as cured and loss to follow-up from DR-TB treatment. A structured questionnaire was used to collect information by interviewing the subjects as respondents. Obtained data was analyzed potential risk factors for loss to follow-up in DR-TB patients.Results: A total of 280 subjects were included in this study. Sex, working status, income, and body mass index showed significant different between cured and loss to follow-up DR-TB patients with p-value of 0.013, 0.010, 0.007, and 0.006, respectively. Regression analysis revealed the significant association of loss to follow-up with negative attitude towards treatment (p<0.001, OR=1.201; 95% CI=1.104-1.306), limitation of social support (p<0.001, OR=1.163; 95% CI=1.072-1.262), health service (p<0.001, OR=2.193; 95% CI=1.562-3.080)), and limitation of economic status (p=0.034, OR=1.135; 95% CI=1.009-1.276)). Conclusions: Male patients, jobless, non-regular employee, lower income, and underweight BMI were found higher in LTFU patients. Negative attitude towards treatment, limitation of social support, dissatisfaction of health service, and limitation of economic status are risk factors for LTFU in DR-TB patients. Non-compliance to treatment is complex, we suggest that the involvement and support from the combination of health ministry, labor and employment ministry, and social ministry may help to resolve the complex problems of LTFU in DR-TB patients..
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Preprint| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
ResearchSquare.com - (2021) vom: 16. Juli Zur Gesamtaufnahme - year:2021 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Soedarsono, Soedarsono [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-713063/v1 |
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| PPN (Katalog-ID): |
XRA033451060 |
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| 520 | |a Abstract Background: Drug-resistant TB (DR-TB) is the barrier for global TB elimination efforts with a lower treatment success rate. Loss to follow-up in DR-TB is a serious problem caused mortality and morbidity for patients and leads to wide spreading of DR-TB to their family and the wider community, as well as wasting health resources. Prevention and management loss to follow-up is crucial to reduce mortality, prevent further spread of DR-TB, and inhibit the development and transmission of more extensively drug-resistant strains of bacteria. Study about the factors associated with loss to follow-up is needed to develop appropriate strategies to prevent DR-TB patients become loss to follow-up. This study was conducted to identify the risk factors correlated with loss to follow-up in DR-TB patients, using questionnaires in the point of view from patients.Methods: An observational study with cross-sectional design was conducted. Study subjects were all DR-TB patients who have declared as cured and loss to follow-up from DR-TB treatment. A structured questionnaire was used to collect information by interviewing the subjects as respondents. Obtained data was analyzed potential risk factors for loss to follow-up in DR-TB patients.Results: A total of 280 subjects were included in this study. Sex, working status, income, and body mass index showed significant different between cured and loss to follow-up DR-TB patients with p-value of 0.013, 0.010, 0.007, and 0.006, respectively. Regression analysis revealed the significant association of loss to follow-up with negative attitude towards treatment (p<0.001, OR=1.201; 95% CI=1.104-1.306), limitation of social support (p<0.001, OR=1.163; 95% CI=1.072-1.262), health service (p<0.001, OR=2.193; 95% CI=1.562-3.080)), and limitation of economic status (p=0.034, OR=1.135; 95% CI=1.009-1.276)). Conclusions: Male patients, jobless, non-regular employee, lower income, and underweight BMI were found higher in LTFU patients. Negative attitude towards treatment, limitation of social support, dissatisfaction of health service, and limitation of economic status are risk factors for LTFU in DR-TB patients. Non-compliance to treatment is complex, we suggest that the involvement and support from the combination of health ministry, labor and employment ministry, and social ministry may help to resolve the complex problems of LTFU in DR-TB patients. | ||
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