Loss to follow-up among adolescents with tuberculosis in Gaborone, Botswana.

TitleLoss to follow-up among adolescents with tuberculosis in Gaborone, Botswana.
Publication TypeJournal Article
Year of Publication2016
AuthorsEnane LA, Lowenthal ED, Arscott-Mills T, Matlhare M, Smallcomb LS, Kgwaadira B, Coffin SE, Steenhoff AP
JournalInt J Tuberc Lung Dis
Volume20
Issue10
Pagination1320-1325
Date Published2016 Oct
ISSN1815-7920
Abstract

SETTING: Nine high-burden public tuberculosis (TB) clinics in Gaborone, Botswana.

OBJECTIVE: To describe clinical characteristics and outcomes among adolescents with TB and compare loss to follow-up (LTFU) rates with that among youth and adult cases.

DESIGN: Retrospective cohort study of TB cases registered from 2012 to 2014. Clinical characteristics and treatment outcomes were compared among adolescents (age 10-19 years), youth (20-24 years) and a systematic sample of adults (⩾25 years).

RESULTS: We analyzed 120 adolescent, 210 youth, and 548 adult cases. Adolescents had twice the risk of LTFU over adults (RR 2.0, 95%CI 1.1-3.7, P = 0.03), and higher LTFU than youth; this was not significant (RR 1.4, 95%CI 0.7-2.9, P = 0.32). Of those with human immunodeficiency virus (HIV) infection, 8/35 (22.9%) adolescents were LTFU, compared with 3/51 (5.9%) youth, and 25/407 (6.1%) adults (P = 0.001). In a multivariable model, adolescence (OR 3.0, 95%CI 1.3-6.5, P < 0.01), HIV positivity (OR 2.2, 95%CI 1.1-4.5, P = 0.02), and extra-pulmonary TB (OR 2.2, 95%CI 1.2-4.0, P = 0.01) were each associated with LTFU.

CONCLUSION: Adolescents treated for TB had greater LTFU than youth and adults, particularly in the setting of TB-HIV coinfection. Further work should clarify the generalizability of these findings and investigate poor outcomes among adolescents with TB.

DOI10.5588/ijtld.16.0060
Alternate JournalInt. J. Tuberc. Lung Dis.
PubMed ID27725042