The Association Between Loss to Follow-up Intuberculosis Patients and Substance Abuse and Homelessness at the Georgetown Chest Clinic From January 2020 – December 2021
Introduction
Background: Many tuberculosis (TB) treatment failures, relapses, retreatment,anddevelopment of multiple drug resistance among retreatmentcasesglobally were mainly due to non-adherence and loss to follow-up.
Objectives
Objective. This study aims to evaluate the association between socialpredictors and loss to follow-up (LTFU) in tuberculosis patients; andthus, discuss existing interventions and new initiative(s) to preventLTFU in this target population.
Method
Method: This is a case-control retrospective study done by retrievingsecondarydata from charts of LTFU TB patients (cases) and patientswithsuccessful treatment outcomes (controls) selected in a ratio of1:2 ofcases to controls, registered from January 1, 2020, to December31, 2021, at the Georgetown Chest Clinic. The Statistical PackageforSocial Sciences (SPSS) V.29.0. was used for data analysiswhereunivariate, multivariate, and multiple regression analysis wasdoneutilizing the backward elimination technique. A p-value of <0.05wasdeemed significant.
Results
Results: A total of 153 charts were utilized in this study with 51(33.3%) categorized as LTFU. Age, sex, ethnicity, employment, HIVstatus, cigarette smoking, alcohol use, illicit drug use, andhomelessness were assessed in this study, and only cigarettesmokingand homelessness proved to be statistically significant(p<0.05).Cigarette smoking had an AOR of 4.931 (95% CI 1.818-13.373, p <0.001),and homelessness had an AOR of 13.090 (95% CI1.124-152.396, p 0.005). Illicit drug use yielded a p-value of 0.012(OR 2.545, 95% CI1.226-5.285) in the univariate analysis but thiswas found to bebecause of confounding.
Conclusion
Conclusion: This study illustrates the importance of early interventionafterdiagnosis, individualized to each patient depending ontheirpresenting predictive social factor/s. The development of a”RiskAssessment Form” that recognizes predictors from the veryfirstclinic visit would allow timely action, as would providing incentivesfor every clinic visit.