ArticleBMC infectious diseases2026
The cascade of care for latent tuberculosis infection in Malaysia: a cohort analysis.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to examine the cascade of care for individuals with latent tuberculosis infection (LTBI) in Malaysia and explore the determinants of non-initiation and non-completion of tuberculosis preventive treatment (TPT).
methodsA retrospective cohort study was conducted using the national LTBI surveillance database, including all individuals diagnosed with LTBI from 2021 to 2022. LTBI was diagnosed based on a positive tuberculin skin test (TST) or interferon-gamma release assay (IGRA). Logistic regression analyses were performed to examine the determinants of TPT non-initiation and non-completion.
resultsOf the 10,820 individuals diagnosed with LTBI, 7,516 (69.5%) initiated TPT; of these, 5,169 (68.8%) completed TPT. Healthcare workers had higher odds of TPT non-initiation (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], 1.10–1.47). Conversely, those aged < 18 years (aOR, 0.78; 95% CI, 0.68–0.88), aged ≥ 65 years (aOR, 0.71; 95% CI, 0.57–0.87), history of TB contact (aOR, 0.49; 95% CI, 0.43–0.56), and diabetes mellitus (aOR, 0.56; 95% CI, 0.39–0.78) had lower odds of non-initiation. Non-Malaysians had increased odds of non-initiation (aOR, 2.89; 95% CI, 2.38–3.52) and non-completion (aOR, 1.48; 95% CI, 1.04–2.08). Individuals who tested only TST-positive also had increased odds of non-initiation (aOR, 2.29; 95% CI, 2.08–2.51) and non-completion (aOR, 1.42; 95% CI, 1.24–1.61) compared to those who underwent IGRA testing. Finally, individuals in congregate settings had lower odds of non-initiation (aOR, 0.10; 95% CI, 0.03–0.23) and non-completion (aOR, 0.30; 95% CI, 0.14–0.56).
conclusionsThis study estimated that two-thirds of individuals with LTBI initiated TPT, and that two-thirds of those who initiated TPT completed it. The identified determinants offer evidence to inform future efforts to improve LTBI programmatic management.
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