Factors associated with being lost to follow-up before completing tuberculosis treatment: analysis of surveillance data

• Published in: Epidemiology and infection Vol. 141; no. 6; pp. 1223 - 1231
• Main Authors: MILLETT, E. R. C., NOEL, D., MANGTANI, P., ABUBAKAR, I., KRUIJSHAAR, M. E.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.06.2013
• Subjects: Adolescent; Adult; Age Factors; Aged; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Clinical outcomes; Country of birth; Disease models; Disease risks; Drug resistance; England - epidemiology; Ethnic groups; Female; Fundamental and applied biological sciences. Psychology; Health outcomes; Humans; Infant; Logistic Models; Lost to Follow-Up; Male; Microbiology; Middle Aged; Mycobacterium; Mycobacterium tuberculosis; Northern Ireland - epidemiology; Original Papers; Patients; Population Surveillance; Public health; Pulmonary tuberculosis; Risk Factors; Sex Factors; Sputum - microbiology; Surveillance; Tuberculosis; Tuberculosis, Pulmonary - drug therapy; Variables; Wales - epidemiology; White people; Young Adult; England; Northern Ireland; Wales; United Kingdom > UK; United States > US; British Isles, England; British Isles, Northern Ireland; British Isles, Wales; Epidemiology; treatment outcome; UK; tuberculosis; Data analysis; Treatment
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S095026881200163X

Completion of treatment is key to tuberculosis control. Using national surveillance data we assessed factors associated with tuberculosis patients being lost to follow-up before completing treatment (‘lost’). Patients reported in England, Wales and Northern Ireland between 2001 and 2007 who were lost 12 months after beginning treatment were compared to those who completed, or were still on treatment, using univariable and multivariable logistic regression. Of 41 120 patients, men [adjusted odds ratio (aOR) 1·29; 95% confidence interval (CI) 1·23–1·35], 15- to 44-year-olds (P<0·001), and patients with pulmonary sputum smear-positive disease (aOR 1·25, 95% CI 1·12–1·45) were at higher risk of being lost. Those recently arrived in the UK were also at increased risk, particularly those of the White ethnic group (aOR 6·39, 95% CI 4·46–9·14). Finally, lost patients had a higher risk of drug resistance (aOR 1·41, 95% CI 1·17–1·69). Patients at risk of being lost require enhanced case management and novel case retention methods are needed to prevent this group contributing towards onward transmission.