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Tuberculosis treatment loss to follow-up in children exposed at home: A prospective cohort study

Meredith B Brooks1,2, Brittney J van de Water3, Leonid Lecca2,4

  • 1Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.

Journal of Global Health
|August 16, 2024
PubMed

Insights

More than 10% of children with tuberculosis (TB) treatment were lost to follow-up (LTFU). Family-centered care may improve treatment completion for pediatric TB cases.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pediatrics

Background:

  • Loss to follow-up (LTFU) is a major challenge in tuberculosis (TB) treatment and care.
  • Understanding drivers of LTFU in children is crucial, as their treatment relies on adult caregivers.
  • This study focuses on identifying risk factors for LTFU in pediatric TB patients within a household contact setting.

Purpose of the Study:

  • To identify risk factors associated with loss to follow-up (LTFU) among children undergoing tuberculosis (TB) treatment.
  • To inform the development of targeted support services for families affected by pediatric TB.

Main Methods:

  • A prospective cohort study was conducted with household contacts in Lima, Peru, from 2009 to 2012.
  • Multilevel logistic regression analysis was used to explore individual-level characteristics.
  • Risk factors for LTFU were identified among children initiated on TB treatment.

Main Results:

  • Out of 154 children diagnosed with TB and initiated on treatment, 20 (13.0%) were LTFU.
  • A significant proportion of LTFU occurred within the first seven months of treatment initiation.
  • Children with index patients older than 25 years had lower odds of LTFU compared to those with younger index patients.

Conclusions:

  • Over 10% of children with TB in this cohort experienced LTFU.
  • An integrated, family-centered approach to TB prevention and management could potentially reduce LTFU.
  • Addressing family-centered needs may improve treatment adherence and completion in pediatric TB cases.
Abstract

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