Mohd Ghazali Sumarni, Cheong Kee Chee, Md Nadzri Mohamad Nadzmi, Mohd Ghazali Nur'Ain, Cheng Lim Mei, Ahmad Lonny Chen Rong Qi, Kamarudin Mohd Kamarulariffin, Ahmad Nur Ar Rabiah, Zulkifli Asrul Anuar, Ling Cheong Yoon, Ruslan Qistina, Singh Sarbhan, Gill Balvinder Singh, Razali Asmah, Md Iderus Nuur Hafizah
Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia.
Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia.
Trop Med Infect Dis. 2025 Aug 12;10(8):226. doi: 10.3390/tropicalmed10080226.
Adherence to the 6-month tuberculosis (TB) treatment regimen is challenging due to its duration and side effects, with various factors influencing patient compliance. A retrospective cross-sectional study was conducted among newly diagnosed pulmonary TB (pTB) patients in Selangor, Malaysia, undergoing treatment in government primary care clinics and hospitals. Patients who were lost to follow-up (LTFU) within the first six months were determined by reviewing patient records and the national TB registry. Logistic regression analysis identified sociodemographic and clinical factors associated with LTFU. Of the 699 pTB patients, 55 (7.9%) were lost to follow-up. Factors significantly associated with LTFU included age (higher in 25-44-year-olds, adjusted odds ratio (aOR): 2.83), unmarried status (aOR: 2.17), lower education level (aOR: 6.13), being a smoker (aOR: 2.65), and unawareness of TB diagnosis (aOR: 38.14). A significant interaction was found between education level and awareness of diagnosis, with unawareness having a stronger association with LTFU among higher-educated patients. Young adults, those with a lower education level, unmarried individuals, smokers, and those unaware of their TB diagnosis are at higher risk of LTFU. These factors can be used for rapid risk assessment. Intensive counselling and health education at treatment initiation, particularly for at-risk patients, are crucial for preventing LTFU.
由于6个月的结核病治疗方案疗程长且有副作用，坚持该方案具有挑战性，多种因素会影响患者的依从性。在马来西亚雪兰莪州的政府初级保健诊所和医院接受治疗的新诊断肺结核（pTB）患者中进行了一项回顾性横断面研究。通过查阅患者记录和国家结核病登记册来确定在头六个月内失访（LTFU）的患者。逻辑回归分析确定了与失访相关的社会人口统计学和临床因素。在699例肺结核患者中，55例（7.9%）失访。与失访显著相关的因素包括年龄（25 - 44岁人群中较高，调整后的优势比（aOR）：2.83）、未婚状态（aOR：2.17）、教育水平较低（aOR：6.13）、吸烟（aOR：2.65）以及对结核病诊断不知情（aOR：38.14）。发现教育水平与诊断知晓情况之间存在显著交互作用，在高学历患者中，不知情与失访的关联更强。年轻人、教育水平较低者、未婚者、吸烟者以及对自己的结核病诊断不知情者失访风险更高。这些因素可用于快速风险评估。在治疗开始时进行强化咨询和健康教育，特别是针对高危患者，对于预防失访至关重要。
