1Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
2Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Am J Trop Med Hyg. 2020 Sep;103(3):1050-1056. doi: 10.4269/ajtmh.19-0415.
Identifying predictors of loss to follow-up (LTFU; treatment lapse ≥ 2 months) among people with tuberculosis (TB) may assist programmatic efforts in controlling the spread of TB. Newly diagnosed smear-positive TB patients were enrolled in the Regional Prospective Observational Research for TB study in Puducherry and Tamil Nadu, India. Treatment records were used to identify LTFU of those who were enrolled from May 2014 through December 2017. This nested case-control study evaluated male TB patients. Predictors were assessed using multivariable logistic regression. Of 425 men with TB, 82 (19%) were LTFU. In the adjusted analyses of males, divorced/separated marital status (adjusted odds ratio [aOR] 3.80; 95% CI: 1.39-10.38) and at-risk alcohol use (aOR 1.92; 95% CI: 1.12-3.27) were significant predictors for increased risk of LTFU, and diabetes was a significant predictor for decreased risk of LTFU (aOR 0.52; 95% CI: 0.29-0.92). Of 53 men with recorded date of last treatment visit, 23 (43%) and 43 (81%) had LTFU within the first 2 and first 4 months of treatment, respectively. Addressing at-risk alcohol use and providing more intensive follow-up could lead to improved treatment completion.
确定结核病（TB）患者失访（治疗中断≥2 个月）的预测因素可能有助于控制 TB 的传播。在印度的 Puducherry 和泰米尔纳德邦，新诊断为涂片阳性的 TB 患者被纳入区域前瞻性观察性研究 TB 研究中。使用治疗记录来确定那些于 2014 年 5 月至 2017 年 12 月期间入组的患者的失访情况。这项嵌套病例对照研究评估了男性 TB 患者。使用多变量逻辑回归评估了预测因素。在 425 名男性 TB 患者中，82 名（19%）失访。在对男性进行的调整分析中，离异/分居的婚姻状况（调整后的优势比 [aOR] 3.80；95%置信区间：1.39-10.38）和有风险的饮酒行为（aOR 1.92；95%置信区间：1.12-3.27）是增加失访风险的显著预测因素，而糖尿病是降低失访风险的显著预测因素（aOR 0.52；95%置信区间：0.29-0.92）。在有记录的最后一次治疗就诊日期的 53 名男性中，分别有 23 名（43%）和 43 名（81%）在治疗的前 2 个月和前 4 个月内失访。解决有风险的饮酒问题并提供更强化的随访可能会提高治疗完成率。
