Schnaubelt E R, Charles M, Richard M, Fitter D L, Morose W, Cegielski J P
Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Epidemic Intelligence Service Program, Atlanta, Georgia, USA.
Public Health Action. 2018 Dec 21;8(4):154-161. doi: 10.5588/pha.18.0043.
Tuberculosis (TB) treatment facilities in Haiti. To assess factors associated with loss to follow-up (LTFU) among patients receiving treatment for tuberculosis (TB) in Haiti. We analyzed Haiti's national surveillance data for patients started on anti-tuberculosis treatment from 2011 to 2015 to determine factors associated with LTFU using multivariable logistic regression and describe LTFU in terms of subnational units to target future intervention strategies. We also conducted a survival analysis to estimate hazard ratios of factors associated with time to LTFU. Of 81 490 TB cases reported, 7423 (9.1%) were LTFU during anti-tuberculosis treatment, increasing from 7.1% in 2011 to 10.3% in 2015. Six high-volume facilities had significantly higher rates of LTFU (14.3-31.9%) than the rest of the country, accounting for 18.8% of all TB cases reported, but 41.7% of all LTFU patients. Male sex, previous treatment history, and human immunodeficiency virus infection were associated with higher rates of LTFU. The median time to LTFU was 94 days. A small number of facilities accounted for disproportionately high rates of LTFU. These results identify characteristics of facilities and individuals leading to concentrated interventions to reduce LTFU and improve treatment success.
海地的结核病治疗设施。为评估海地接受结核病(TB)治疗患者失访(LTFU)的相关因素。我们分析了海地2011年至2015年开始接受抗结核治疗患者的国家监测数据,使用多变量逻辑回归确定与LTFU相关的因素,并按次国家级单位描述LTFU情况,以确定未来的干预策略。我们还进行了生存分析,以估计与LTFU时间相关因素的风险比。在报告的81490例结核病例中,7423例(9.1%)在抗结核治疗期间失访,从2011年的7.1%增至2015年的10.3%。六个高流量设施的LTFU率(14.3 - 31.9%)显著高于该国其他地区,占报告的所有结核病例的18.8%,但占所有失访患者的41.7%。男性、既往治疗史和人类免疫缺陷病毒感染与较高的LTFU率相关。LTFU的中位时间为94天。少数设施的LTFU率过高。这些结果确定了导致集中干预以减少LTFU并提高治疗成功率的设施和个体特征。