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. 2022 May 1;26(5):399-405.
doi: 10.5588/ijtld.21.0111.

Risk factors for TB in Australia and their association with delayed treatment completion

N J Coorey  1 , L Kensitt  1 , J Davies  1 , E Keller  1 , M Sheel  2 , K Chani  2 , S Barry  3 , R Boyd  4 , J Denholm  5 , K Watts  6 , G Fox  7 , C Lowbridge  8 , R Perera  9 , J Waring  10 , B Marais  11 , K Viney  12
Affiliations

Risk factors for TB in Australia and their association with delayed treatment completion

N J Coorey et al. Int J Tuberc Lung Dis. .

Abstract
in English, French

BACKGROUND: Australia has a low incidence of TB and has committed to eliminating the disease. Identification of risk factors associated with TB is critical to achieving this goal.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.

CONTEXTE :: L’incidence de la TB en Australie est faible et le pays s’est engagé à éliminer la maladie. Afin d’atteindre cet objectif, il est essentiel d’identifier les facteurs de risque associés à la TB.

MÉTHODES :: Nous avons réalisé une étude de cohorte prospective auprès de personnes sous traitement antituberculeux dans quatre juridictions du pays. Les facteurs de risque et leur association avec un retard d’achèvement du traitement (d’au moins 1 mois) ont été analysés par analyses univariées et régression logistique multivariée.

RÉSULTATS :: Au total, 402 personnes ont répondu aux enquêtes initiales. La plupart (86,1%) étaient nées à l’étranger. Un contact avec un cas de TB a été rapporté par 19,4% d’entre elles. Diabète sucré (10,2%), absence de domicile fixe (9,2%), tabagisme (8,7%), consommation excessive d’alcool (6,0%) et troubles mentaux (6,2%) étaient d’autres facteurs de risque courants. Pendant la période de suivi, 24,8% des patients ont connu un retard d’achèvement du traitement, associé à des évènements indésirables (34,1%, OR ajusté [ORa] 6,67 ; IC 95% 3,36–13,27), une consommation excessive d’alcool (6,0% ; aOR 21,94 ; IC 95% 6,03–79,85) et à une co-infection par le VIH (2,7% ; aOR 8,10 ; IC 95% 1,16–56,60).

CONCLUSIONS :: Nous avons identifié les facteurs de risque de TB et leur association avec un retard d’achèvement du traitement, tous n’étant pas recueillis en routine à des fins de surveillance. L’identification de ces facteurs de risque devrait faciliter les soins centrés sur le patient et aider l’Australie à éliminer la TB.

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Conflict of interest statement

Conflicts of interest: none declared.

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