ArticlePloS one2021
Early mortality in tuberculosis patients initially lost to follow up following diagnosis in provincial hospitals and primary health care facilities in Western Cape, South Africa.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Ultrasononography in Managing Extrapulmonary Tuberculosis: A Randomized, Controlled, Parallel, Superiority, Open-Label Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Bridging the Gap Between Treatment and Accountability: DR-TB Outcomes and Governance Signals in Rural Eastern Cape, South Africa (2020-2024).Infectious disease reports · 2026Article
- Epidemiology of Pediatric Tuberculosis in the Western Cape: A Population-Based Study (2017-2023).Pediatrics · 2026Article
- Article
- Mortality hazards after treatment completion of pulmonary tuberculosis in a tertiary hospital in Uganda.IJID regions · 2025Article
- Tuberculosis and HIV coinfection: Progress and challenges towards reducing incidence and mortality.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Review
- Article
- Cost-effectiveness of Low-complexity Screening Tests in Community-based Case-finding for Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Observational
- Reducing Initial Loss to Follow-up Among People With Bacteriologically Confirmed Tuberculosis: LINKEDin, a Quasi-experimental Study in South Africa.Open forum infectious diseases · 2024Article
- Article
- Interventions and implementation considerations for reducing pre-treatment loss to follow-up in adults with pulmonary tuberculosis: A scoping review.F1000Research · 2024Article
- Optimal Timing of Antiretroviral Therapy Initiation in Children and Adolescents With Human Immunodeficiency Virus-Associated Pulmonary Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- A qualitative exploration of continuity of TB care in clinics after discharge from hospitals in Cape Town, South Africa.BMC health services research · 2022Article
- Early interactions with newly diagnosed TB patients in hospital can support linkage to care.Public health action · 2022Article
- The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions.The Lancet. Respiratory medicine · 2022Review
- New Quinoline-Urea-Benzothiazole Hybrids as Promising Antitubercular Agents: Synthesis, In Vitro Antitubercular Activity, Cytotoxicity Studies, and In Silico ADME Profiling.Pharmaceuticals (Basel, Switzerland) · 2022Article
- Toward a conceptual framework of the acceptability of tuberculosis treatment in children using a theory generative approach.PLOS global public health · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
In South Africa, low tuberculosis (TB) treatment coverage and high TB case fatality remain important challenges. Following TB diagnosis, patients must link with a primary health care (PHC) facility for initiation or continuation of antituberculosis treatment and TB registration. We aimed to evaluate mortality among TB patients who did not link to a TB treatment facility for TB treatment within 30 days of their TB diagnosis, i.e. who were "initial loss to follow-up (ILTFU)" in Cape Town, South Africa. We prospectively included all patients with a routine laboratory or clinical diagnosis of TB made at PHC or hospital level in Khayelitsha and Tygerberg sub-districts in Cape Town, using routine TB data from an integrated provincial health data centre between October 2018 and March 2020. Overall, 74% (10,208/13,736) of TB patients were diagnosed at PHC facilities and ILTFU was 20.0% (2,742/13,736). Of ILTFU patients, 17.1% (468/2,742) died, with 69.7% (326/468) of deaths occurring within 30 days of diagnosis. Most ILTFU deaths (85.5%; 400/468) occurred in patients diagnosed in hospital. Multivariable logistic regression identified increasing age, HIV positive status, and hospital-based TB diagnosis (higher in the absence of TB treatment initiation and being ILTFU) as predictors of mortality. Although hospitals account for a modest proportion of diagnosed TB patients they have high TB-associated mortality. A hospital-based TB diagnosis is a critical opportunity to identify those at high risk of early and overall mortality. Interventions to diagnose TB before hospital admission, improve linkage to TB treatment following diagnosis, and reduce mortality in hospital-diagnosed TB patients should be prioritised.
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