K K K Htet1, K T Soe1, A M V Kumar2, S Saw1, H M Win Maung3, Z Myint4, T M M Khine4, S T Aung3. 1. Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar. 2. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France, The Union, South-East Asia Office, New Delhi, India. 3. National TB Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw. 4. National TB Programme (Lower Myanmar), Ministry of Health and Sports, Yangon, Myanmar.
Abstract
SETTING: Regional tuberculosis (TB) centres of the Yangon and Mandalay Regions of Myanmar, which account for 65% of all notified rifampicin-resistant tuberculosis (RR-TB) cases countrywide. OBJECTIVE: To determine 1) initial loss to follow-up (LTFU), 2) treatment delay, and 3) factors associated with initial LTFU and treatment delay among RR-TB patients residing in the Yangon and Mandalay regions diagnosed using Xpert® during January-August 2016. DESIGN: This was a retrospective cohort study. Each diagnosed patient was tracked in the drug-resistant TB treatment registers of the Yangon and Mandalay regional treatment centres for January-December 2016 using patient name, age, sex, township and date of diagnosis. If the diagnosed patient was not found in the treatment register by 31 December 2016, he/she was considered 'initial LTFU'. RESULTS: Of the 1037 RR-TB patients diagnosed, 310 (30%) experienced initial LTFU, which was significantly higher among patients aged 55 years and among those diagnosed in the Mandalay Region. A treatment delay of >1 month was observed in 440 (70%) patients (median delay 41 days). Delay was uniformly high across patient subgroups, and was not associated with any factor. CONCLUSION: Initial LTFU and treatment delays among RR-TB patients were high. Future studies using qualitative research methods are needed to ascertain the reasons for this observation.
SETTING: Regional tuberculosis (TB) centres of the Yangon and Mandalay Regions of Myanmar, which account for 65% of all notified rifampicin-resistant tuberculosis (RR-TB) cases countrywide. OBJECTIVE: To determine 1) initial loss to follow-up (LTFU), 2) treatment delay, and 3) factors associated with initial LTFU and treatment delay among RR-TB patients residing in the Yangon and Mandalay regions diagnosed using Xpert® during January-August 2016. DESIGN: This was a retrospective cohort study. Each diagnosed patient was tracked in the drug-resistant TB treatment registers of the Yangon and Mandalay regional treatment centres for January-December 2016 using patient name, age, sex, township and date of diagnosis. If the diagnosed patient was not found in the treatment register by 31 December 2016, he/she was considered 'initial LTFU'. RESULTS: Of the 1037 RR-TB patients diagnosed, 310 (30%) experienced initial LTFU, which was significantly higher among patients aged 55 years and among those diagnosed in the Mandalay Region. A treatment delay of >1 month was observed in 440 (70%) patients (median delay 41 days). Delay was uniformly high across patient subgroups, and was not associated with any factor. CONCLUSION: Initial LTFU and treatment delays among RR-TB patients were high. Future studies using qualitative research methods are needed to ascertain the reasons for this observation.
Authors: Anthony D Harries; Ajay M V Kumar; Srinath Satyanarayana; Pruthu Thekkur; Yan Lin; Riitta A Dlodlo; Mohammed Khogali; Rony Zachariah Journal: Trop Med Infect Dis Date: 2020-04-16
Authors: Ko Ko Htwe; Nang Thu Thu Kyaw; Ajay M V Kumar; Khine Wut Yee Kyaw; Myo Minn Oo; Thandar Thwin; Saw Saw; Si Thu Aung Journal: Trop Med Health Date: 2019-05-02
Authors: Sharofiddin Yuldashev; Nargiza Parpieva; Salikhdjan Alimov; Laziz Turaev; Khasan Safaev; Kostyantyn Dumchev; Jamshid Gadoev; Oleksandr Korotych; Anthony D Harries Journal: Int J Environ Res Public Health Date: 2021-04-28 Impact factor: 3.390
Authors: Anthony D Harries; Yan Lin; Ajay M V Kumar; Srinath Satyanarayana; Kudakwashe C Takarinda; Riitta A Dlodlo; Rony Zachariah; Piero Olliaro Journal: F1000Res Date: 2018-07-05