HIV prevalence and determinants of loss-to-follow-up in adolescents and young adults with tuberculosis in Cape Town
PLoS ONE, ISSN: 1932-6203, Vol: 14, Issue: 2, Page: e0210937
2019
- 38Citations
- 164Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations38
- Citation Indexes34
- 34
- CrossRef4
- Policy Citations4
- Policy Citation4
- Captures164
- Readers164
- 164
Article Description
TB remains a leading cause of mortality and morbidity in sub-Saharan Africa, due to the HIV epidemic. As TB treatment is lengthy, the completion of the full course of treatment may be especially challenging for young people. We therefore aimed to identify the extent of and reasons underlying loss to follow-up from TB treatment among young people in Cape Town. Accordingly, we reviewed the outcomes of young people treated for TB in Cape Town during 2009-2013, across three age groups: younger adolescents (10-14 years); older adolescents; (15-19 years) and young adults (20-24 years). We employed logistic regression analysis to identify risk factors for loss from TB care. 23,737 patients aged 10-24 were treated for drug sensitive TB over the study period. Of these, the HIV co-infection prevalence was 18.5% for younger adolescents, 12.9% for older adolescents and 33.1% for young adults. From age 16, HIV prevalence increased disproportionately among young women: by age 22, over 50% of women were TB/HIV co-infected compared to 14% of men. TB treatment success (cure plus completion) was 84.4%, while 1.7% of patients died, 9.5% were lost-to follow-up and 0.4% failed treatment. Being an older adolescent (aOR 1.75 [95% CI: 1.38-2.21]) or young adult (aOR: 1.96 [95% CI: 1.57-2.45]) increased the risk of loss-to-follow up, relative to being a younger adolescent. Further risk factors for loss from TB care were male gender (aOR: 1.33 [95% CI:1.20-1.46]), being a TB/HIV co-infected young person (aOR 1.74 [95% CI: 1.57-1.93]) and having had prior treatment for TB (aOR 3.17 [95% CI 2.87-3.51]). We identified risk factors for loss to follow-up and highlighted the need to focus on HIV prevention and retention in TB care among young people. TB care tailored to the needs of young people could improve patient retention, similar to improved outcomes reported by youth friendly HIV clinics.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85061157361&origin=inward; http://dx.doi.org/10.1371/journal.pone.0210937; http://www.ncbi.nlm.nih.gov/pubmed/30721239; https://dx.plos.org/10.1371/journal.pone.0210937; https://dx.doi.org/10.1371/journal.pone.0210937; https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210937
Public Library of Science (PLoS)
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