Predictors of loss to follow-up of tuberculosis cases under the DOTS programme in Namibia

Dan Kibuule, Philomien Aiases, Nunurai Ruswa, Timothy William Rennie, Roger K. Verbeeck, Brian Godman, Mwangana Mubita

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Abstract

Background In Namibia, one out of every 25 cases of tuberculosis (TB) is “lost to follow-up” (LTFU). This has impacted negatively on national efforts to end the disease by 2035. The aim of this study was to determine the trends and predictors of LTFU under the directly observed treatment short-course (DOTS) programme in Namibia. Methods The study involved a retrospective longitudinal analysis of a nationwide cohort of TB cases registered under the DOTS programme in Namibia from 2006 to 2015. The trends and predictors of LTFU among cases in the National Electronic TB Register of the National TB and Leprosy Program were respectively determined by interrupted time series and multivariate logistic regression analyses using R-Studio software. Results Out of 104 203 TB cases, 3775 (3.6%) were LTFU. A quarter (26%) of cases with poor outcomes were due to LTFU. The annual decline in cases of LTFU was significant between the first (2005–2010) and second (2010–2015) medium-term plan period for TB programme implementation (p=0.002). The independent predictors of LTFU were male sex (p=0.004), 15–24 years age group (p=0.03), provider of treatment (p<0.001), intensive phase (p=0.047) and living in border/transit regions (p<0.001). HIV co-infection and TB regimen were not significant predictors of LTFU. Conclusions There were declining trends in LTFU in Namibia. DOTS programmes should integrate socioeconomic interventions for young and middle-aged adult male TB cases to reduce LTFU.
Original languageEnglish
Article number00030-2019
Number of pages10
JournalERJ Open Research
Volume6
Issue number1
DOIs
Publication statusPublished - 16 Mar 2020

Keywords

  • tuberculosis
  • DOTS program
  • Namibia

Cite this

Kibuule, D., Aiases, P., Ruswa, N., Rennie, T. W., Verbeeck, R. K., Godman, B., & Mubita, M. (2020). Predictors of loss to follow-up of tuberculosis cases under the DOTS programme in Namibia. ERJ Open Research, 6(1), [00030-2019]. https://doi.org/10.1183/23120541.00030-2019