Risk of loss to follow-up among tuberculosis patients in South Korea: whom should we focus on?
- 주제(키워드) tuberculosis , loss to follow-up , public-private mix , risk factors , vulnerability
- 주제(기타) Public, Environmental & Occupational Health
- 설명문(일반) [Kim, Hyung Woo; Kim, Ju Sang] Catholic Univ Korea, Div Pulm & Crit Care Med, Dept Internal Med, Incheon St Marys Hosp,Coll Med, Seoul, South Korea; [Min, Jinsoo] Catholic Univ Korea, Seoul St Marys Hosp, Div Pulm & Crit Care Med, Coll Med,Dept Internal Med, Seoul, South Korea; [Ko, Yousang] Hallym Univ, Kangdong Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med,Coll Med, Seoul, South Korea; [Oh, Jee Youn] Korea Univ, Guro Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med,Coll Med, Seoul, South Korea; [Jeong, Yun-Jeong] Dongguk Univ, Ilsan Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Goyang, South Korea; [Lee, Eun Hye] Yonsei Univ, Yongin Severance Hosp, Div Pulmonol Allergy & Crit Care Med, Dept Internal Med,Coll Med, Seoul 06273, South Korea; [Yang, Bumhee] Chungbuk Natl Univ, Div Pulm & Crit Care Med, Coll Med, Dept Internal Med, Cheongju, South Korea; [Koo, Hyeon-Kyoung; Lee, Sung-Soon] Inje Univ, Coll Med, Div Pulm & Crit Care Med, Dept Internal Med,Ilsan Paik Hosp, Goyang, South Korea; [Park, Jae Seuk] Dankook Univ, Coll Med, Dept Internal Med, Div Pulm Med, Cheonan, South Korea; [Park, Kwang Joo] Ajou Univ, Sch Med, Dept Pulm & Crit Care Med, Suwon, South Korea; [Chang, Jung Hyun] Ewha Womans Univ, Mokdong Hosp, Coll Med, Div Pulm & Crit Care Med,Dept Internal Med, Seoul, South Korea; [Joh, Joonsung] Natl Med Ctr, Dept Internal Med, Div Pulm & Crit Care Med, Seoul, South Korea; [Lee, Min Ki] Pusan Natl Univ, Sch Med, Dept Internal Med, Pusan, South Korea
- 등재 SCIE, SSCI, SCOPUS
- OA유형 Green Published; Gold Open Access
- 발행기관 FRONTIERS MEDIA SA
- 발행년도 2023
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000213353
- 본문언어 영어
- Published As https://doi.org/10.3389/fpubh.2023.1247772
- PubMed 37927864
초록/요약
IntroductionIn South Korea, public-private mix (PPM) has been a key strategy in national tuberculosis (TB) control program. This study aimed to identify rate of loss to follow-up (LTFU) among TB patients in nationwide PPM institutions and their risk factors.MethodsA nationwide prospective observational study including drug susceptible TB patients diagnosed from the 1st day to the 10th day of every month between July 2018 and December 2020 in PPM institutions was designed. Multivariable survival models in which death and failure were designated as events with competing risk were used to investigate risk factors for LTFU.ResultsA total of 14,942 patients were included. Of them, 356 (2.4%) had an LTFU. Risk factors for LTFU were: underweight patients (adjusted hazard ratio (aHR): 1.47, 95% CI: 1.12-1.92), patients living alone (aHR: 1.43, 95% CI: 1.16-1.76), heavy drinkers (aHR: 1.67, 95% CI: 1.16-2.39), those with malignancy (aHR: 1.49, 95% CI: 1.07-2.05), foreigners (aHR: 5.96, 95% CI: 4.51-7.89), and those with previous TB history reported as an unfavorable outcome (aHR: 4.43, 95% CI: 2.77-7.08). Effect of age on LTFU was not significant. Brief interruption of anti-TB treatment (less than two months) in current session was associated with subsequent LTFU [adjusted odds ratio: 13.09 (10.29-16.66)].ConclusionIdentifying vulnerability of patients such as living alone, being heavy alcoholics, being foreigners or having previous TB history reported as an unfavorable outcome is required. Thorough case management for these vulnerable groups could be feasible with collaboration between public and private sectors.
more