Evidence map›Paper›PMID 39396938›Full record

Observational studyBMC infectious diseases2024

Understanding the impact of pandemics on long-term medication adherence: directly observed therapy in a tuberculosis treatment cohort pre- and post-COVID-19 lockdowns.

Victoria Overbeck, Samantha Malatesta, Tara Carney, Bronwyn Myers, Charles D H Parry, Charles R Horsburgh, Danie Theron, Laura F White, Robin M Warren, Karen R Jacobson and 1 more

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02840877 (The Impact of Alcohol Consumption on Tuberculosis Treatment Outcomes), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT02840877 nacompletednot on this map

The Impact of Alcohol Consumption on Tuberculosis Treatment Outcomes

TypeinterventionalSponsorBoston Medical CenterRan2017 to 2023Enrolled303ConditionsTuberculosis, Alcohol Consumption, Treatment Adverse EffectArmsDOT Adherence Monitoring
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. The impact of COVID-19 pandemic on treatment adherence of patients with breast cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  4. 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

11 authors.

Victoria OverbeckSection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Samantha MalatestaDepartment of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
Tara CarneyMental Health, Alcohol, Substance Use & Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa.
Bronwyn MyersMental Health, Alcohol, Substance Use & Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa.
Charles D H ParryMental Health, Alcohol, Substance Use & Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa.
Charles R HorsburghSection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Danie TheronBrewelskloof Hospital, Worcester, South Africa.
Laura F WhiteDepartment of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
Robin M WarrenSouth Africa Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Stellenbosch University, Cape Town, South Africa.
Karen R JacobsonSection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Tara C BoutonSection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA. tcbouton@bu.edu.

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI CURT G BECKWITH, DEBBIE M. CHENG · 1998 to 2026
$51.7M
The impact of alcohol consumption on TB treatment outcomesR01AI119037 · NIAID · BOSTON MEDICAL CENTER · PI JACOBSON, KAREN R · 2016 to 2020
$3.3M
Understanding HIV's impact on RR/MDR-TB development and transmission through genomicsK23AI152930 · NIAID · BOSTON MEDICAL CENTER · PI BOUTON, TARA CATHERINE · 2021 to 2025
$1.0M
National Institute of Allergy and Infectious Diseases K23AI152930National Institute of Allergy and Infectious Diseases R01AI119037NIAID NIH HHS K23 AI152930NIAID NIH HHS P30 AI042853
6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa.

methodsWe analyzed data from 263 observational study participants undergoing drug susceptible (DS)-TB DOT between May 2017 to March 2022. Participants enrolled before October 2019 were considered 'pre-COVID-19' and those enrolled after September 2020 were considered 'post-COVID-19 lockdown groups. Negative binomial regression models were used to compare DOT non-adherence rates between the two lockdown groups. We then conducted a sensitivity analysis which only included participants enrolled in the immediate period following the first COVID-19 lockdown.

resultsDOT non-adherence rate was higher in the post-COVID-19 lockdown group (aIRR = 1.42, 95% CI = 1.04-1.96; p = 0.028) compared to pre-COVID-19 lockdown period, adjusting for age, sex, employment status, household hunger, depression risk, and smoked substance use. DOT non-adherence was highest immediately following the initial lockdown (aIRR = 1.74, 95% CI = 1.17-2.67; p = 0.006).

conclusionThe COVID-19 lockdowns adversely effected adherence to TB DOT in the period after lockdowns were lifted. The change in DOT adherence persisted even after adjusting for socioeconomic and behavioral variables. We need a better understanding of what treatment adherence barriers were exacerbated by COVID-19 lockdowns to improve outcomes in post-pandemic times.

trial registrationClinicalTrials.gov Registration Number: NCT02840877. Registered on 19 July 2016.

Indexed as

Antitubercular AgentsCOVID-19Directly Observed TherapyDrug MonitoringTuberculosisAdultCohort StudiesFemaleHumansMaleMiddle AgedPandemicsSARS-CoV-2South AfricaAntitubercular AgentsAdherenceDrug-susceptible TBMycobacterium tuberculosisSARS-CoV-2South Africa

Identifiers

PMID39396938
PMCPMC11475609

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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.