Risk factors for TB in Australia and their association with delayed treatment completion
METHODS: We undertook a prospective cohort study involving persons receiving TB treatment in four Australian jurisdictions. Risk factors and their association with delayed treatment completion (treatment delayed by at least 1 month) were analysed using univariate analyses and multivariate logistic regression.
RESULTS: Baseline surveys were completed for 402 persons with TB. Most (86.1%) were born overseas. Exposure to a person with TB was reported by 19.4%. Diabetes mellitus (10.2%), homelessness (9.2%), cigarette smoking (8.7%), excess alcohol consumption (6.0%) and mental illness (6.2%) were other common risk factors. At follow-up, 24.8% of patients had delayed treatment completion, which was associated with adverse events (34.1%, aOR 6.67, 95% CI 3.36–13.27), excess alcohol consumption (6.0%, aOR 21.94, 95% CI 6.03–79.85) and HIV co-infection (2.7%, aOR 8.10, 95% CI 1.16–56.60).
CONCLUSIONS: We identified risk factors for TB and their association with delayed treatment completion, not all of which are routinely collected for surveillance purposes. Recognition of these risk factors should facilitate patient-centred care and assist Australia in reaching TB elimination.
Keywords: Australia; TB; risk factors; surveillance; tuberculosis
Document Type: Research Article
Affiliations: 1: Australian National University Medical School, Canberra ACT, Australia 2: Research School of Population Health, Australian National University College of Health and Medicine, Australian National University, Canberra ACT, Australia 3: South Australia Health, Adelaide, SA, Australia 4: Northern Territory Health, Darwin, NT, Australia 5: Victorian Tuberculosis Program, Melbourne Health, VIC, Australia, Department of Infectious Diseases, Doherty Institute, The University of Melbourne, VIC, Australia 6: Victorian Tuberculosis Program, Melbourne Health, VIC, Australia 7: Sydney Medical School-Central, The University of Sydney, Sydney, NSW, Australia 8: Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia 9: Western Australia Health, Perth, WA, Australia 10: Western Australia Health, Perth, WA, Australia, Western Australia Tuberculosis Control Program, Perth, WA, Australia 11: Centre for Research Excellence in Tuberculosis (TB-CRE), The University of Sydney, Sydney, NSW, Australia, Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), The University of Sydney, Sydney, NSW, Australia 12: Research School of Population Health, Australian National University College of Health and Medicine, Australian National University, Canberra ACT, Australia, School of Public Health, The University of Sydney, Sydney, NSW, Australia, Department of Global Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
Publication date: May 1, 2022
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