Meehan, Sue-Ann ORCID: https://orcid.org/0000-0002-0826-1833, Hesseling, Anneke C ORCID: https://orcid.org/0000-0001-9399-9834, Boulle, Andrew ORCID: https://orcid.org/0000-0002-7713-8062, Chetty, Jolene, Connell, Lucy ORCID: https://orcid.org/0000-0002-9893-7584, Dlamini-Miti, Nomthandazo J, Dunbar, Rory ORCID: https://orcid.org/0000-0003-1852-5940, Du Preez, Karen, George, Gavin, Hoddinott, Graeme ORCID: https://orcid.org/0000-0001-5915-8126, Jennings, Karen, Marx, Florian M ORCID: https://orcid.org/0000-0003-4630-4598, Mudaly, Vanessa, Naidoo, Pren ORCID: https://orcid.org/0000-0002-2681-7110, Ndlovu, Neo ORCID: https://orcid.org/0000-0003-4029-4552, Ngozo, Jacqueline, Smith, Mariette, Strauss, Michael, Tanna, Gaurang ORCID: https://orcid.org/0000-0002-0692-2175, Vanqa, Nosivuyile ORCID: https://orcid.org/0000-0002-2774-5622, von Delft, Arne ORCID: https://orcid.org/0000-0002-8785-9672 and Osman, Muhammad ORCID: https://orcid.org/0000-0003-3818-9729 (2023) Reducing initial loss to follow up among people with bacteriologically confirmed tuberculosis: LINKEDin, a quasi-experimental study in South Africa. Open Forum Infectious Diseases, 11 (1):ofad648. ISSN 2328-8957 (Online) (doi:10.1093/ofid/ofad648)

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Abstract

Every person diagnosed with tuberculosis (TB) needs to initiate treatment. The WHO estimated 61% of people who developed TB in 2021 were included in a TB treatment registration system. Initial loss to follow up (ILTFU) is the loss of persons to care between diagnosis and treatment initiation/registration. LINKEDin, a quasi-experimental study, evaluated the effect of two interventions (hospital-recording and an alert-and-response patient management intervention) in six sub-districts across three high-TB burden provinces of South Africa. Using integrated electronic reports, we identified all persons diagnosed with TB (Xpert MTB/RIF positive) in hospital and at primary healthcare facilities. We prospectively determined linkage to care at 30 days after TB diagnosis. We calculated the risk of ILTFU during the baseline and intervention periods and the relative risk reduction in ILTFU between these periods. We found a relative reduction in ILTFU of 42.4% (95%CI:28.5,53.7) in KwaZulu Natal (KZN) and 22.3% (95%CI:13.3,30.4) in the Western Cape (WC) with no significant change in Gauteng. In KZN and the WC, the relative reduction in ILTFU appeared greater in sub-districts where the alert-and-response patient management intervention was implemented; KZN (49.3% (95%CI:32.4,62) vs 32.2% (95%CI:5.4,51.4)); and WC (34.2% (95%CI:20.9,45.3) vs 13.4% (95%CI:0.7,24.4)). We reported a notable reduction in ILTFU in two provinces using existing routine health service data and applying a simple intervention to trace and recall those not linked to care. TB programs need to consider ILTFU as a priority and develop interventions specific to their context to ensure improved linkage to care.

Item Type:	Article
Uncontrolled Keywords:	tuberculosis; initial loss to follow up; linkage to care
Subjects:	Q Science > Q Science (General) Q Science > QR Microbiology R Medicine > R Medicine (General)
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	15 Jan 2024 16:14
URI:	http://gala.gre.ac.uk/id/eprint/45172

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