Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital

Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital

A major challenge for most tuberculosis programs is the inability of tuberculosis patients to complete treatment for one reason or another. Failure to complete the treatment contributes to the emergence of multidrug-resistant TB. This study aimed to evaluate the risk factors for time to loss to foll...

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Published in:Archives of public health = Archives belges de santé publique Vol. 81; no. 1; p. 117
Main Authors: Fufa, Daba Bulto, Diriba, Tadele Akeba, Dame, Kenenisa Tadesse, Debusho, Legesse Kassa
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 25-06-2023
BioMed Central
BMC
Subjects:
Bacteriology
Care and treatment
Competing risks
Demographics
Drug resistance in microorganisms
Epidemiology
Hazard functions
Health risk assessment
Health surveillance
Hospitals
Loss-to-follow-up
Measurement techniques
Medical diagnosis
Medical research
Medical treatment
Medicine, Experimental
Microscopy
Patient compliance
Patient education
Patient-centered care
Patients
Public health
Registration
Respiratory diseases
Risk assessment
Risk factors
Rural populations
Sexually transmitted diseases
STD
Survival analysis
Tuberculosis
Ethiopia
Loss-to-follow-up
Hazard functions
Competing risks
Tuberculosis
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Summary:A major challenge for most tuberculosis programs is the inability of tuberculosis patients to complete treatment for one reason or another. Failure to complete the treatment contributes to the emergence of multidrug-resistant TB. This study aimed to evaluate the risk factors for time to loss to follow-up treatment by considering death as a competing risk event among tuberculosis patients admitted to directly observed treatment short course at Ambo General Hospital, Ambo, Ethiopia. Data collected from 457 tuberculosis patients from January 2018 to January 2022 were used for the analysis. The cause-specific hazard and sub-distribution hazard models for competing risks were used to model the outcome of interest and to identify the prognostic factors associated to treatment loss to follow-up. Loss to follow-up was used as an outcome measure and death as a competing event. Of the 457 tuberculosis patients enrolled, 54 (11.8%) were loss to follow-up their treatment and 33 (7.2%) died during the follow up period. The median time of loss to follow-up starting from the date of treatment initiation was 4.2 months. The cause-specific hazard and sub-distribution hazard models revealed that sex, place of residence, HIV status, contact history, age and baseline weights of patients were significant risk factors associated with time to loss to follow-up treatment. The findings showed that the estimates of the covariates effects were different for the cause specific and sub-distribution hazard models. The maximum relative difference observed for the covariate between the cause specific and sub-distribution hazard ratios was 12.2%. Patients who were male, rural residents, HIV positive, and aged 41 years or older were at higher risk of loss to follow-up their treatment. This underlines the need that tuberculosis patients, especially those in risk categories, be made aware of the length of the directly observed treatment short course and the effects of discontinuing treatment.
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ISSN:0778-7367
2049-3258
2049-3258
DOI:10.1186/s13690-023-01130-2