Pretreatment attrition and treatment initiation delay among rifampicin-resistant tuberculosis patients in Lagos, Nigeria: a retrospective cohort study.
Trans R Soc Trop Med Hyg
; 116(12): 1154-1161, 2022 12 02.
Article
de En
| MEDLINE
| ID: mdl-35710310
ABSTRACT
BACKGROUND:
Assessing associated factors of pretreatment attrition and treatment delays among rifampicin-resistant tuberculosis (RR-TB) patients could serve as a valuable tool to control and prevent its community spread. We assessed the factors associated with pretreatment attrition and treatment initiation delays among RR-TB patients in Lagos, Nigeria.METHODS:
A retrospective cohort study was conducted involving secondary program data of RR-TB patients diagnosed using the Xpert MTB/RIF assay and initiated on treatment between 1 January 2015 and 31 December 2017 in Lagos. Factors associated with pretreatment attrition and treatment initiation delay were determined using logistic regression.RESULTS:
Of the 606 RR-TB patients diagnosed during the review period, 135 (22.3%) had pretreatment attrition. Previously treated TB patients had a 2.4-fold greater chance of having pretreatment attrition than new RR-TB patients (adjusted odds ratio 2.4 [95% confidence interval 1.2-5.0]). The median time to treatment initiation was 29 d (interquartile range [IQR] 18-49). It was longer for new RR-TB patients (49 d [IQR 36-59]) than previously treated TB patients (28 d [IQR 17-44]). A total of 47% had long treatment delays. Being newly diagnosed with RR-TB was associated with long treatment delays.CONCLUSIONS:
The pretreatment attrition rate and proportion of RR-TB patients with treatment delays were high. Pragmatic approaches to address the high pretreatment attrition and treatment delays in Lagos, Nigeria, are urgently needed.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tuberculose multirésistante
/
Antibiotiques antituberculeux
/
Mycobacterium tuberculosis
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limites:
Humans
Pays/Région comme sujet:
Africa
Langue:
En
Journal:
Trans R Soc Trop Med Hyg
Année:
2022
Type de document:
Article
Pays d'affiliation:
Nigeria