Clinic Presentation Delay and Tuberculosis Treatment Outcomes in the Lake Victoria Region of East Africa: A Multi-Site Prospective Cohort Study

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Citation

Mulholland, Grace E.; Herce, Michael E.; Okech, Brenda A.; Jeremiah, Kidola; Bahemuka, Ubaldo M.; Kwena, Zachary A.; Nanyonjo, Gertrude; Seeley, Janet; Pettifor, Audrey E.; & Emch, Michael, et al. (2023). Clinic Presentation Delay and Tuberculosis Treatment Outcomes in the Lake Victoria Region of East Africa: A Multi-Site Prospective Cohort Study. PLOS Global Public Health, 3(8), e0002259. PMCID: PMC10468066

Abstract

In the Lake Victoria region of East Africa, little is known about delays between tuberculosis (TB) symptom onset and presentation at a clinic. Associations between clinic presentation delay and TB treatment outcomes are also poorly understood. In 2019, we abstracted data from routine TB treatment records for all adults (n = 776) initiating TB treatment in a 6-month period across 12 health facilities near Lake Victoria. We interviewed 301 cohort members and assessed whether they experienced a clinic presentation delay longer than 6 weeks. We investigated potential clinical and demographic correlates of clinic presentation delay and examined the association between clinic presentation delay and an unfavorable TB treatment outcome (death, loss to follow-up, or treatment failure). Clinic presentation delay was common, occurring among an estimated 54.7% (95% CI: 48.9%, 61.2%) of cohort members, though no specific correlates were identified. Clinic presentation delay was slightly associated with unfavorable TB treatment outcomes. The 180-day risk of an unfavorable outcome was 14.2% (95% CI: 8.0%, 20.4%) among those with clinic presentation delay, compared to 12.7% (95% CI: 5.1%, 20.3%) among those presenting earlier. Multi-level community-based interventions may be necessary to reduce clinic presentation delays in communities near Lake Victoria.

URL

http://dx.doi.org/10.1371/journal.pgph.0002259

Reference Type

Journal Article

Year Published

2023

Journal Title

PLOS Global Public Health

Author(s)

Mulholland, Grace E.
Herce, Michael E.
Okech, Brenda A.
Jeremiah, Kidola
Bahemuka, Ubaldo M.
Kwena, Zachary A.
Nanyonjo, Gertrude
Seeley, Janet
Pettifor, Audrey E.
Emch, Michael
Weir, Sharon S.
Edwards, Jessie K.

Article Type

Regular

PMCID

PMC10468066

Continent/Country

Uganda
Tanzania
Kenya

ORCiD

Emch - 0000-0003-2642-965X
Weir - 0000-0001-6014-1460
Pettifor - 0000-0002-3387-0817
Edwards, J -0000-0002-1741-335X