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Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital
BACKGROUND: 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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290796/ https://www.ncbi.nlm.nih.gov/pubmed/37357257 http://dx.doi.org/10.1186/s13690-023-01130-2 |
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author | Fufa, Daba Bulto Diriba, Tadele Akeba Dame, Kenenisa Tadesse Debusho, Legesse Kassa |
author_facet | Fufa, Daba Bulto Diriba, Tadele Akeba Dame, Kenenisa Tadesse Debusho, Legesse Kassa |
author_sort | Fufa, Daba Bulto |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-023-01130-2. |
format | Online Article Text |
id | pubmed-10290796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102907962023-06-26 Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital Fufa, Daba Bulto Diriba, Tadele Akeba Dame, Kenenisa Tadesse Debusho, Legesse Kassa Arch Public Health Research BACKGROUND: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-023-01130-2. BioMed Central 2023-06-25 /pmc/articles/PMC10290796/ /pubmed/37357257 http://dx.doi.org/10.1186/s13690-023-01130-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Fufa, Daba Bulto Diriba, Tadele Akeba Dame, Kenenisa Tadesse Debusho, Legesse Kassa Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital |
title | Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital |
title_full | Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital |
title_fullStr | Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital |
title_full_unstemmed | Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital |
title_short | Competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at Ambo General Hospital |
title_sort | competing risk models to evaluate the factors for time to loss to follow-up among tuberculosis patients at ambo general hospital |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290796/ https://www.ncbi.nlm.nih.gov/pubmed/37357257 http://dx.doi.org/10.1186/s13690-023-01130-2 |
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