Evidence map›Paper›PMID 39710664›Full record

ArticleBMC health services research2024

Pre-diagnosis and pre-treatment loss to follow-up and associated factors among patients with presumed tuberculosis and those diagnosed in Uganda.

Rebecca Nuwematsiko, Noah Kiwanuka, Solomon T Wafula, Mary Nakafeero, Lydia Nakanjako, Henry Luzze, Stavia Turyahabwe, Juliet N Sekandi, Lynn Atuyambe, Esther Buregyeya

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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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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

2 citing papers in PubMed.

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4 · The record

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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

10 authors.

Rebecca NuwematsikoSchool of Public Health, Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda. rnuwematsiko@musph.ac.ug.
Noah KiwanukaSchool of Public Health, Department of Epidemiology and Biostatistics, Makerere University, Kampala, Uganda.
Solomon T WafulaSchool of Public Health, Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda.
Mary NakafeeroSchool of Public Health, Department of Epidemiology and Biostatistics, Makerere University, Kampala, Uganda.
Lydia NakanjakoSchool of Public Health, Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda.
Henry LuzzeNational TB and Leprosy Program, Ministry of Health, Kampala, Uganda.
Stavia TuryahabweNational TB and Leprosy Program, Ministry of Health, Kampala, Uganda.
Juliet N SekandiCollege of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, Georgia, USA.
Lynn AtuyambeSchool of Public Health, Department of Community Health and Behavioural Sciences, Makerere University, Kampala, Uganda.
Esther BuregyeyaSchool of Public Health, Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda.

Funding

Emory/Georgia TB Research Advancement Center (TRAC)P30AI168386 · NIAID · EMORY UNIVERSITY · PI Jeffrey M Collins · 2022 to 2026
$5.8M
European and Developing Countries Clinical Trials Partnership TMA2018SF-2472NIAID NIH HHS P30 AI168386
6 · The paper itself

Abstract

backgroundLoss to follow-up (LTFU) of patients with presumed tuberculosis (TB) before completing the diagnostic process (pre-diagnosis LTFU) and before initiating treatment for those diagnosed (pre-treatment LTFU) is a challenge in the realization of the End TB Strategy. We assessed the proportion of pre-diagnosis and pre-treatment LTFU and associated factors among patients with presumed TB and those diagnosed in the selected health facilities.

methodsThis was a retrospective cohort study involving a review of routinely collected data from presumptive, laboratory and TB treatment registers from January 2019 to December 2022. The study was conducted in three general hospitals and one lower-level health center IV in Central Uganda. We defined pre-diagnosis LTFU as failure to test for TB and obtain results within 30 days from the date of being presumed and pre-treatment LTFU as failure to initiate TB treatment within 14 days from the date of diagnosis. Modified Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of factors associated with pre-diagnosis and pre-treatment LTFU.

resultsOf the 13,064 patients with presumed TB, 39.9% were aged 25 to 44 years, and 57.1% were females. Almost a third, 28.3% (3,699/13.064) experienced pre-diagnosis LTFU and 13.7% (163/1187) did not initiate treatment within 14 days from being diagnosed. Pre-diagnosis LTFU was more likely to occur among patients aged 0-14 years (adj PR 1.1, 95% CI: 1.06,1.24), females (adj.PR=1.06, 95% CI: 1.01, 1.12) and those with no record of place of residence (adj. PR=2.7, 95% CI: 2.54, 2.93). In addition, patients with no record of phone contact were more likely to be LTFU, (adj. PR=1.1, 95% CI: 1.05, 1.17). Pre-treatment LTFU was also more likely among patients with no record of place of residence (adj PR 7.1, 95% CI: 5.13,9.85) and those with no record of phone contact (adj PR 2.2, 95% CI: 1.63,2.86). Patients presumed from the HIV clinics were 40% less likely to experience pre-treatment LTFU compared to those in the outpatient departments (adj PR 0.6, 95% CI: 0.41,0.88).

conclusionHigh proportions of pre-diagnosis and pre-treatment LTFU were observed in this study. This calls for urgent interventions at these time points in the TB care cascade to be able to realise the End TB Strategy.

Indexed as

Lost to Follow-UpTuberculosisAdolescentAdultChildChild, PreschoolFemaleHumansInfantMaleMiddle AgedRetrospective StudiesUgandaYoung AdultDiagnosis loss to followTreatment loss to followTuberculosis, loss to followUp, preUp, Uganda

Identifiers

PMID39710664
PMCPMC11665076

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LicenceCC BY-NC-ND
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Registered trials

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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.