Cargando…

Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam

BACKGROUND: Tuberculosis (TB) remains a major cause of avoidable deaths. Economic migrants represent a vulnerable population due to their exposure to medical and social risk factors. These factors expose them to higher risks for TB incidence and poor treatment outcomes. METHODS: This cross-sectional...

Descripción completa

Detalles Bibliográficos
Autores principales: Vo, Luan Nguyen Quang, Codlin, Andrew James, Forse, Rachel Jeanette, Nguyen, Hoa Trung, Vu, Thanh Nguyen, Van Truong, Vinh, Do, Giang Chau, Nguyen, Lan Huu, Le, Giang Truong, Caws, Maxine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017549/
https://www.ncbi.nlm.nih.gov/pubmed/32050913
http://dx.doi.org/10.1186/s12879-020-4865-7
_version_ 1783497218030829568
author Vo, Luan Nguyen Quang
Codlin, Andrew James
Forse, Rachel Jeanette
Nguyen, Hoa Trung
Vu, Thanh Nguyen
Van Truong, Vinh
Do, Giang Chau
Nguyen, Lan Huu
Le, Giang Truong
Caws, Maxine
author_facet Vo, Luan Nguyen Quang
Codlin, Andrew James
Forse, Rachel Jeanette
Nguyen, Hoa Trung
Vu, Thanh Nguyen
Van Truong, Vinh
Do, Giang Chau
Nguyen, Lan Huu
Le, Giang Truong
Caws, Maxine
author_sort Vo, Luan Nguyen Quang
collection PubMed
description BACKGROUND: Tuberculosis (TB) remains a major cause of avoidable deaths. Economic migrants represent a vulnerable population due to their exposure to medical and social risk factors. These factors expose them to higher risks for TB incidence and poor treatment outcomes. METHODS: This cross-sectional study evaluated WHO-defined TB treatment outcomes among economic migrants in an urban district of Ho Chi Minh City, Viet Nam. We measured the association of a patient’s government-defined residency status with treatment success and loss to follow-up categories at baseline and performed a comparative interrupted time series (ITS) analysis to assess the impact of community-based adherence support on treatment outcomes. Key measures of interest of the ITS were the differences in step change (β(6)) and post-intervention trend (β(7)). RESULTS: Short-term, inter-province migrants experienced lower treatment success (aRR = 0.95 [95% CI: 0.92–0.99], p = 0.010) and higher loss to follow-up (aOR = 1.98 [95% CI: 1.44–2.72], p < 0.001) than permanent residents. Intra-province migrants were similarly more likely to be lost to follow-up (aOR = 1.86 [95% CI: 1.03–3.36], p = 0.041). There was evidence that patients > 55 years of age (aRR = 0.93 [95% CI: 0.89–0.96], p < 0.001), relapse patients (aRR = 0.89 [95% CI: 0.84–0.94], p < 0.001), and retreatment patients (aRR = 0.62 [95% CI: 0.52–0.75], p < 0.001) had lower treatment success rates. TB/HIV co-infection was also associated with lower treatment success (aRR = 0.77 [95% CI: 0.73–0.82], p < 0.001) and higher loss to follow-up (aOR = 2.18 [95% CI: 1.55–3.06], p < 0.001). The provision of treatment adherence support increased treatment success (IRR(β(6)) = 1.07 [95% CI: 1.00, 1.15], p = 0.041) and reduced loss to follow-up (IRR(β(6)) = 0.17 [95% CI: 0.04, 0.69], p = 0.013) in the intervention districts. Loss to follow-up continued to decline throughout the post-implementation period (IRR(β(7)) = 0.90 [95% CI: 0.83, 0.98], p = 0.019). CONCLUSIONS: Economic migrants, particularly those crossing provincial borders, have higher risk of poor treatment outcomes and should be prioritized for tailored adherence support. In light of accelerating urbanization in many regions of Asia, implementation trials are needed to inform evidence-based design of strategies for this vulnerable population.
format Online
Article
Text
id pubmed-7017549
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70175492020-02-20 Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam Vo, Luan Nguyen Quang Codlin, Andrew James Forse, Rachel Jeanette Nguyen, Hoa Trung Vu, Thanh Nguyen Van Truong, Vinh Do, Giang Chau Nguyen, Lan Huu Le, Giang Truong Caws, Maxine BMC Infect Dis Research Article BACKGROUND: Tuberculosis (TB) remains a major cause of avoidable deaths. Economic migrants represent a vulnerable population due to their exposure to medical and social risk factors. These factors expose them to higher risks for TB incidence and poor treatment outcomes. METHODS: This cross-sectional study evaluated WHO-defined TB treatment outcomes among economic migrants in an urban district of Ho Chi Minh City, Viet Nam. We measured the association of a patient’s government-defined residency status with treatment success and loss to follow-up categories at baseline and performed a comparative interrupted time series (ITS) analysis to assess the impact of community-based adherence support on treatment outcomes. Key measures of interest of the ITS were the differences in step change (β(6)) and post-intervention trend (β(7)). RESULTS: Short-term, inter-province migrants experienced lower treatment success (aRR = 0.95 [95% CI: 0.92–0.99], p = 0.010) and higher loss to follow-up (aOR = 1.98 [95% CI: 1.44–2.72], p < 0.001) than permanent residents. Intra-province migrants were similarly more likely to be lost to follow-up (aOR = 1.86 [95% CI: 1.03–3.36], p = 0.041). There was evidence that patients > 55 years of age (aRR = 0.93 [95% CI: 0.89–0.96], p < 0.001), relapse patients (aRR = 0.89 [95% CI: 0.84–0.94], p < 0.001), and retreatment patients (aRR = 0.62 [95% CI: 0.52–0.75], p < 0.001) had lower treatment success rates. TB/HIV co-infection was also associated with lower treatment success (aRR = 0.77 [95% CI: 0.73–0.82], p < 0.001) and higher loss to follow-up (aOR = 2.18 [95% CI: 1.55–3.06], p < 0.001). The provision of treatment adherence support increased treatment success (IRR(β(6)) = 1.07 [95% CI: 1.00, 1.15], p = 0.041) and reduced loss to follow-up (IRR(β(6)) = 0.17 [95% CI: 0.04, 0.69], p = 0.013) in the intervention districts. Loss to follow-up continued to decline throughout the post-implementation period (IRR(β(7)) = 0.90 [95% CI: 0.83, 0.98], p = 0.019). CONCLUSIONS: Economic migrants, particularly those crossing provincial borders, have higher risk of poor treatment outcomes and should be prioritized for tailored adherence support. In light of accelerating urbanization in many regions of Asia, implementation trials are needed to inform evidence-based design of strategies for this vulnerable population. BioMed Central 2020-02-12 /pmc/articles/PMC7017549/ /pubmed/32050913 http://dx.doi.org/10.1186/s12879-020-4865-7 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Vo, Luan Nguyen Quang
Codlin, Andrew James
Forse, Rachel Jeanette
Nguyen, Hoa Trung
Vu, Thanh Nguyen
Van Truong, Vinh
Do, Giang Chau
Nguyen, Lan Huu
Le, Giang Truong
Caws, Maxine
Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
title Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
title_full Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
title_fullStr Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
title_full_unstemmed Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
title_short Tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in Ho Chi Minh City, Viet Nam
title_sort tuberculosis among economic migrants: a cross-sectional study of the risk of poor treatment outcomes and impact of a treatment adherence intervention among temporary residents in an urban district in ho chi minh city, viet nam
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017549/
https://www.ncbi.nlm.nih.gov/pubmed/32050913
http://dx.doi.org/10.1186/s12879-020-4865-7
work_keys_str_mv AT voluannguyenquang tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT codlinandrewjames tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT forseracheljeanette tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT nguyenhoatrung tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT vuthanhnguyen tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT vantruongvinh tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT dogiangchau tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT nguyenlanhuu tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT legiangtruong tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam
AT cawsmaxine tuberculosisamongeconomicmigrantsacrosssectionalstudyoftheriskofpoortreatmentoutcomesandimpactofatreatmentadherenceinterventionamongtemporaryresidentsinanurbandistrictinhochiminhcityvietnam