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Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study
Geographic mobility may disrupt continuity of care and contribute to poor clinical outcomes among people receiving treatment for tuberculosis (TB). This may occur especially where health services are not well coordinated across international borders, particularly in lower and middle income country s...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241360/ https://www.ncbi.nlm.nih.gov/pubmed/37276192 http://dx.doi.org/10.1371/journal.pgph.0001992 |
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author | Mulholland, Grace E. Herce, Michael E. Bahemuka, Ubaldo M. Kwena, Zachary A. Jeremiah, Kidola Okech, Brenda A. Bukusi, Elizabeth Okello, Elialilia S. Nanyonjo, Gertrude Ssetaala, Ali Seeley, Janet Emch, Michael Pettifor, Audrey Weir, Sharon S. Edwards, Jessie K. |
author_facet | Mulholland, Grace E. Herce, Michael E. Bahemuka, Ubaldo M. Kwena, Zachary A. Jeremiah, Kidola Okech, Brenda A. Bukusi, Elizabeth Okello, Elialilia S. Nanyonjo, Gertrude Ssetaala, Ali Seeley, Janet Emch, Michael Pettifor, Audrey Weir, Sharon S. Edwards, Jessie K. |
author_sort | Mulholland, Grace E. |
collection | PubMed |
description | Geographic mobility may disrupt continuity of care and contribute to poor clinical outcomes among people receiving treatment for tuberculosis (TB). This may occur especially where health services are not well coordinated across international borders, particularly in lower and middle income country settings. In this work, we describe mobility and the relationship between mobility and unfavorable TB treatment outcomes (i.e., death, loss to follow-up, or treatment failure) among a cohort of adults who initiated TB treatment at one of 12 health facilities near Lake Victoria. We abstracted data from health facility records for all 776 adults initiating TB treatment during a 6-month period at the selected facilities in Kenya, Tanzania, and Uganda. We interviewed 301 cohort members to assess overnight travel outside one’s residential district/sub-county. In our analyses, we estimated the proportion of cohort members traveling in 2 and 6 months following initiation of TB treatment, explored correlates of mobility, and examined the association between mobility and an unfavorable TB treatment outcome. We estimated that 40.7% (95% CI: 33.3%, 49.6%) of people on treatment for TB traveled overnight at least once in the 6 months following treatment initiation. Mobility was more common among people who worked in the fishing industry and among those with extra-pulmonary TB. Mobility was not strongly associated with other characteristics examined, however, suggesting that efforts to improve TB care for mobile populations should be broad ranging. We found that in this cohort, people who were mobile were not at increased risk of an unfavorable TB treatment outcome. Findings from this study can help inform development and implementation of mobility-competent health services for people with TB in East Africa. |
format | Online Article Text |
id | pubmed-10241360 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-102413602023-06-06 Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study Mulholland, Grace E. Herce, Michael E. Bahemuka, Ubaldo M. Kwena, Zachary A. Jeremiah, Kidola Okech, Brenda A. Bukusi, Elizabeth Okello, Elialilia S. Nanyonjo, Gertrude Ssetaala, Ali Seeley, Janet Emch, Michael Pettifor, Audrey Weir, Sharon S. Edwards, Jessie K. PLOS Glob Public Health Research Article Geographic mobility may disrupt continuity of care and contribute to poor clinical outcomes among people receiving treatment for tuberculosis (TB). This may occur especially where health services are not well coordinated across international borders, particularly in lower and middle income country settings. In this work, we describe mobility and the relationship between mobility and unfavorable TB treatment outcomes (i.e., death, loss to follow-up, or treatment failure) among a cohort of adults who initiated TB treatment at one of 12 health facilities near Lake Victoria. We abstracted data from health facility records for all 776 adults initiating TB treatment during a 6-month period at the selected facilities in Kenya, Tanzania, and Uganda. We interviewed 301 cohort members to assess overnight travel outside one’s residential district/sub-county. In our analyses, we estimated the proportion of cohort members traveling in 2 and 6 months following initiation of TB treatment, explored correlates of mobility, and examined the association between mobility and an unfavorable TB treatment outcome. We estimated that 40.7% (95% CI: 33.3%, 49.6%) of people on treatment for TB traveled overnight at least once in the 6 months following treatment initiation. Mobility was more common among people who worked in the fishing industry and among those with extra-pulmonary TB. Mobility was not strongly associated with other characteristics examined, however, suggesting that efforts to improve TB care for mobile populations should be broad ranging. We found that in this cohort, people who were mobile were not at increased risk of an unfavorable TB treatment outcome. Findings from this study can help inform development and implementation of mobility-competent health services for people with TB in East Africa. Public Library of Science 2023-06-05 /pmc/articles/PMC10241360/ /pubmed/37276192 http://dx.doi.org/10.1371/journal.pgph.0001992 Text en © 2023 Mulholland et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Mulholland, Grace E. Herce, Michael E. Bahemuka, Ubaldo M. Kwena, Zachary A. Jeremiah, Kidola Okech, Brenda A. Bukusi, Elizabeth Okello, Elialilia S. Nanyonjo, Gertrude Ssetaala, Ali Seeley, Janet Emch, Michael Pettifor, Audrey Weir, Sharon S. Edwards, Jessie K. Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study |
title | Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study |
title_full | Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study |
title_fullStr | Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study |
title_full_unstemmed | Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study |
title_short | Geographic mobility and treatment outcomes among people in care for tuberculosis in the Lake Victoria region of East Africa: A multi-site prospective cohort study |
title_sort | geographic mobility and treatment outcomes among people in care for tuberculosis in the lake victoria region of east africa: a multi-site prospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241360/ https://www.ncbi.nlm.nih.gov/pubmed/37276192 http://dx.doi.org/10.1371/journal.pgph.0001992 |
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