ArticleBMC public health2020
Is a differentiated care model needed for patients with TB? A cohort analysis of risk factors contributing to unfavourable outcomes among TB patients in two states in South India.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Bridging clinical and social gaps in tuberculosis management: A review of India's differentiated TB care framework.Lung India : official organ of Indian Chest Society · 2026Article
- Tailoring TB services for improved treatment adherence in Ghana - A mixed-methods study.Journal of public health research · 2026Article
- A Qualitative Exploration into a Statewide Differentiated TB Care Initiative Aimed at Reducing TB Deaths.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Article
- Strengthening TB care pathways: Integrating informal and AYUSH practitioners for early diagnosis and referral.PLOS global public health · 2026Article
- Determinants of drop-offs in the targeted universal tuberculosis testing care cascade among people with HIV in rural and urban facilities in South Africa.Southern African journal of HIV medicine · 2026Article
- Artificial Intelligence-augmented public health interventions in India.Health affairs scholar · 2025Article
- Cohort study on association between catastrophic costs and unfavorable tuberculosis treatment outcomes among TB-HIV and TB-diabetes comorbid patients in India.BMC public health · 2024Article
- Tuberculosis-diabetes comorbidities: Mechanistic insights for clinical considerations and treatment challenges.World journal of diabetes · 2024Review
- "As a patient I do not belong to the clinic, I belong to the community." Co-developing a multi-level, person-centred tuberculosis stigma intervention in Cape Town, South Africa.Research square · 2024Article
- Readiness, acceptability, and feasibility of differentiated TB care for COVID-positive pulmonary tuberculosis patients diagnosed in a district in South India: Mixed methods study.Journal of family medicine and primary care · 2024Article
- "As a patient I do not belong to the clinic, I belong to the community": co-developing multi-level, person-centred tuberculosis stigma interventions in Cape Town, South Africa.BMC global and public health · 2024Article
- A mixed methods evaluation of a differentiated care model piloted for TB care in south India.Journal of public health research · 2023Article
- Screening for Severe Illness at Diagnosis Has the Potential to Prevent Early TB Deaths: Programmatic Experience From Karnataka, India.Global health, science and practice · 2022Article
- Determinants of unsuccessful tuberculosis treatment outcome in Northern Red Sea region, Eritrea.PloS one · 2022Article
- Community health workers augment the cascade of TB detection to care in urban slums of two metro cities in India.Journal of global health · 2021Article
- Tuberculosis and comorbidities: treatment challenges in patients with comorbid diabetes mellitus and depression.Therapeutic advances in infectious diseaseReview
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Authors and funding
18 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundTB is a preventable and treatable disease. Yet, successful treatment outcomes at desired levels are elusive in many national TB programs, including India. We aim to identify risk factors for unfavourable outcomes to TB treatment, in order to subsequently design a care model that would improve treatment outcomes among these at-risk patients.
methodsWe conducted a cohort analysis among TB patients who had been recently initiated on treatment. The study was part of the internal program evaluation of a USAID-THALI project, implemented in select towns/cities of Karnataka and Telangana, south India. Community Health Workers (CHWs) under the project, used a pre-designed tool to assess TB patients for potential risks of an unfavourable outcome. CHWs followed up this cohort of patients until treatment outcomes were declared. We extracted treatment outcomes from patient's follow-up data and from the Nikshay portal. The specific cohort of patients included in our study were those whose risk was assessed during July and September, 2018, subsequent to conceptualisation, tool finalisation and CHW training. We used bivariate and multivariate logistic regression to assess each of the individual and combined risks against unfavourable outcomes; death alone, or death, lost to follow up and treatment failure, combined as 'unfavourable outcome'.
resultsA significantly higher likelihood of death and experiencing unfavourable outcome was observed for individuals having more than one risk (AOR: 4.19; 95% CI: 2.47-7.11 for death; AOR 2.21; 95% CI: 1.56-3.12 for unfavourable outcome) or only one risk (AOR: 3.28; 95% CI: 2.11-5.10 for death; AOR 1.71; 95% CI: 1.29-2.26 for unfavourable outcome) as compared to TB patients with no identified risk. Male, a lower education status, an initial weight below the national median weight, co-existing HIV, previous history of treatment, drug-resistant TB, and regular alcohol use had significantly higher odds of death and unfavourable outcome, while age > 60 was only associated with higher odds of death.
conclusionA rapid risk assessment at treatment initiation can identify factors that are associated with unfavourable outcomes. TB programs could intensify care and support to these patients, in order to optimise treatment outcomes among TB patients.
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