Evidence map›Paper›PMID 38412160›Full record

ArticlePLOS global public health2024

Identifying adolescents at risk for suboptimal adherence to tuberculosis treatment: A prospective cohort study.

Silvia S Chiang, Joshua Ray Tanzer, Jeffrey R Starke, Jennifer F Friedman, Betsabe Roman Sinche, Katya León Ostos, Rosa Espinoza Meza, Elmer Altamirano, Catherine B Beckhorn, Victoria E Oliva Rapoport and 2 more

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Silvia S ChiangDepartment of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.ORCID https://orcid.org/0000-0002-2318-3802
Joshua Ray TanzerDepartment of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
Jeffrey R StarkeDepartment of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America.
Jennifer F FriedmanDepartment of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
Betsabe Roman SincheSocios En Salud Sucursal Perú, Lima, Peru.
Katya León OstosSocios En Salud Sucursal Perú, Lima, Peru.
Rosa Espinoza MezaSocios En Salud Sucursal Perú, Lima, Peru.
Elmer AltamiranoSocios En Salud Sucursal Perú, Lima, Peru.
Catherine B BeckhornSocios En Salud Sucursal Perú, Lima, Peru.ORCID https://orcid.org/0000-0002-3685-2104
Victoria E Oliva RapoportDepartment of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.ORCID https://orcid.org/0000-0002-9009-4834
Marco A TovarSocios En Salud Sucursal Perú, Lima, Peru.
Leonid LeccaSocios En Salud Sucursal Perú, Lima, Peru.

Funding

Emerging Infectious Disease Scholars at Brown UniversityR25AI140490 · NIAID · BROWN UNIVERSITY · PI Silvia Shinpei Chiang · 2018 to 2026
$3.0M
Optimizing interventions to mitigate schistosomiasis-related morbidity among pregnant women and childrenK24AI112964 · NIAID · RHODE ISLAND HOSPITAL · PI FRIEDMAN, JENNIFER F · 2015 to 2024
$1.7M
Teens on TB Treatment: Predicting Adherence through Clinical Decision AnalysisK01TW010829 · FIC · RHODE ISLAND HOSPITAL · PI CHIANG, SILVIA SHINPEI · 2017 to 2021
$775k
FIC NIH HHS K01 TW010829NIAID NIH HHS K24 AI112964NIAID NIH HHS R25 AI140490
6 · The paper itself

Abstract

Adolescents account for an estimated 800,000 incident tuberculosis (TB) cases annually and are at risk for suboptimal adherence to TB treatment. Most studies of adolescent TB treatment adherence have used surveillance data with limited psychosocial information. This prospective cohort study aimed to identify risk factors for suboptimal adherence to rifampicin-susceptible TB treatment among adolescents (10-19 years old) in Lima, Peru. We collected psychosocial data using self-administered surveys and clinical data via medical record abstraction. Applying k-means cluster analysis, we grouped participants by psychosocial characteristics hypothesized to impact adherence. Then, we conducted mixed effects regression to compare suboptimal adherence-defined as <90% (missing >10% of doses)-between clusters. Treatment setting (facility vs. home) and drug formulation (single drug vs. fixed dose combination) were interaction terms. Of 249 participants, 90 (36.1%) were female. Median age was 17 (IQR: 15, 16.6) years. We identified three clusters-A, B, and C-of participants based on psychosocial characteristics. Cluster C had the lowest support from caregivers, other family members, and friends; had the weakest motivation to complete TB treatment; were least likely to live with their mothers; and had experienced the most childhood adversity. Among the 118 (47.4%) participants who received facility-based treatment with single drug formulations, adherence did not differ between Clusters A and B, but Cluster C had six-fold odds of suboptimal adherence compared to Cluster A. In Clusters B and C, adherence worsened over time, but only in Cluster C did mean adherence fall below 90% within six months. Our findings have implications for the care of adolescents with TB. When caring for adolescents with low social support and other risk factors, clinicians should take extra measures to reinforce adherence, such as identifying a community health worker or peer to provide treatment support. Implementing newly recommended shorter regimens also may facilitate adherence.

Identifiers

PMID38412160
PMCPMC10898721

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.