Who is more likely to return for TB test results? A survey at three high-burden primary healthcare facilities in Cape Town, South Africa
•To the authors’ knowledge, this is the first large survey to use broad predictors of non-initiation of tuberculosis (TB) treatment.•Previous studies relied on routine data with a limited set of predictors.•TB testers who were not expecting to have TB were less likely to collect their test results.•...
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Veröffentlicht in: | International journal of infectious diseases 2021-12, Vol.113, p.259-267 |
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Sprache: | eng |
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Zusammenfassung: | •To the authors’ knowledge, this is the first large survey to use broad predictors of non-initiation of tuberculosis (TB) treatment.•Previous studies relied on routine data with a limited set of predictors.•TB testers who were not expecting to have TB were less likely to collect their test results.•Testers who tested positive were more likely to collect their results, even before reminder calls.•Cognitive avoidance and postponement behaviour inhibited the initiation of treatment.
In low- and middle-income countries with a high burden of tuberculosis (TB), a large proportion of people who are tested for TB do not return to the health facility to collect their test results and initiate treatment, thus putting themselves at increased risk of adverse outcomes.
This prospective study aimed to identify predictors of returning to the primary health care (PHC) facility to collect TB test results. From 15 August to 15 December 2017, 1105 people who tested for pulmonary TB at three Cape Town PHC facilities were surveyed. Using multi-variate logistic regressions on an analysis sample of 1097 people, three groups of predictors were considered: (i) demographics, health and socio-economic status; (ii) costs and benefits; and (iii) behavioural factors.
Forty-four percent of people tested returned to the PHC facility to collect their test results within the stipulated 2 days, and 68% returned before the end of the study period. Return was strongly and positively correlated with expecting a TB-positive result, cognitive avoidance and postponement behaviour.
Interventions to improve pre-treatment loss to follow-up should target patients who think they do not have TB, and those with a history of postponement behaviour and cognitive avoidance. |
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ISSN: | 1201-9712 1878-3511 |
DOI: | 10.1016/j.ijid.2021.10.015 |