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Challenges of Loss to Follow-up in Tuberculosis Research.

Nissen, T. N., Rose, M. V., Kimaro, G., Bygbjerg, I. C., Mfinanga, S. G. and Ravn, P. (2012) Challenges of Loss to Follow-up in Tuberculosis Research. PloS one, 7 (7). e40183. ISSN 1932-6203

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Abstract

In studies evaluating methods for diagnosing tuberculosis (TB), follow-up to verify the presence or absence of active TB is crucial and high dropout rates may significantly affect the validity of the results. In a study assessing the diagnostic performance of the QuantiFERON®-TB Gold In-Tube test in TB suspect children in Tanzania, factors influencing patient adherence to attend follow-up examinations and reasons for not attending were examined. In 160 children who attended and 102 children who did not attend scheduled 2-month follow-up baseline health characteristics, demographic data and risk factors for not attending follow-up were determined. Qualitative interviews were used to understand patient and caretakers reasons for not returning for scheduled follow-up. Being treated for active tb in the dots program (OR: 4.14; 95% CI:1.99-8.62;p-value<0.001) and receiving money for the bus fare (OR:129; 95% CI 16->100;P-value<0.001) were positive predictors for attending follow-up at 2 months, and 21/85(25%) of children not attending scheduled follow-up had died. Interviews revealed that limited financial resources, i.e. lack of money for transportation and poor communication, were related to non-adherence. Patients lost to follow-up is a potential problem for TB research. Receiving money for transportation to the hospital and communication is crucial for adherence to follow-up conducted at a study facility. Strategies to ensure follow-up should be part of any study protocol.

Item Type: Article
Keywords: Tuberculosis, Tuberculosis Diagnosis, Tuberculosis and HIV Clinics, Hospital Paediatric Ward, Tanga, Tanzania
Subjects: Tuberculosis > Diagnosis
Divisions: Other
Depositing User: Mr Joseph Madata
Date Deposited: 26 Aug 2013 07:27
Last Modified: 26 Aug 2013 07:27
URI: http://ihi.eprints.org/id/eprint/1964

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