Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Jan;8(1):e010592.
doi: 10.1136/bmjgh-2022-010592.

Prevalence and predictive factors of tuberculosis treatment interruption in the Asia region: a systematic review and meta-analysis

Ai Ling Oh  1 , Mohd Makmor-Bakry  2 , Farida Islahudin  1 , Ian Ck Wong  1   3   4
Affiliations
Meta-Analysis

Prevalence and predictive factors of tuberculosis treatment interruption in the Asia region: a systematic review and meta-analysis

Ai Ling Oh et al. BMJ Glob Health. 2023 Jan.

Abstract

Introduction: Tuberculosis (TB) treatment interruption remains a critical challenge leading to poor treatment outcomes. Two-thirds of global new TB cases are mostly contributed by Asian countries, prompting systematic analysis of predictors for treatment interruption due to the variable findings.

Methods: Articles published from 2012 to 2021 were searched through seven databases. Studies that established the relationship for risk factors of TB treatment interruption among adult Asian were included. Relevant articles were screened, extracted and appraised using Joanna Briggs Institute's checklists for cohort, case-control and cross-sectional study designs by three reviewers. Meta-analysis was performed using the random effect model in Review Manager software. The pooled prevalence and predictors of treatment interruption were expressed in ORs with 95% CIs; heterogeneity was assessed using the I2 statistic. The publication bias was visually inspected using the funnel plot.

Results: Fifty eligible studies (658 304 participants) from 17 Asian countries were included. The overall pooled prevalence of treatment interruption was 17% (95% CI 16% to 18%), the highest in Southern Asia (22% (95% CI 16% to 29%)), followed by Eastern Asia (18% (95% CI 16% to 20%)) and South East Asia (16% (95% CI 4% to 28%)). Seven predictors were identified to increase the risk of treatment interruption, namely, male gender (OR 1.38 (95% CI 1.26 to 1.51)), employment (OR 1.43 (95% CI 1.11 to 1.84)), alcohol intake (OR 2.24 (95% CI 1.58 to 3.18)), smoking (OR 2.74 (95% CI 1.98 to 3.78)), HIV-positive (OR 1.50 (95% CI 1.15 to 1.96)), adverse drug reactions (OR 2.01 (95% CI 1.20 to 3.34)) and previously treated cases (OR 1.77 (95% CI 1.39 to 2.26)). All predictors demonstrated substantial heterogeneity except employment and HIV status with no publication bias.

Conclusion: The identification of predictors for TB treatment interruption enables strategised planning and collective intervention to be targeted at the high-risk groups to strengthen TB care and control in the Asia region.

Keywords: Tuberculosis.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
PRISMA flowchart of the review. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Prevalence of TB treatment interruption in the Asia region (n=39). TB, tuberculosis.
Figure 3
Figure 3
Pooled estimate of the male gender as a predictor of TB treatment interruption. TB, tuberculosis.
Figure 4
Figure 4
Funnel plot based on gender dataset.
See this image and copyright information in PMC

References

    1. World Health Organization . Global tuberculosis report. Geneva; 2021.
    1. World Health Organization . Treatment of tuberculosis guidelines. 4 ed. Geneva, 2010. - PubMed
    1. Kruk ME, Schwalbe NR, Aguiar CA. Timing of default from tuberculosis treatment: a systematic review. Trop Med Int Health 2008;13:703–12. 10.1111/j.1365-3156.2008.02042.x - DOI - PubMed
    1. Munro SA, Lewin SA, Smith HJ, et al. . Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med 2007;4:e238. 10.1371/journal.pmed.0040238 - DOI - PMC - PubMed
    1. Nezenega ZS, Perimal-Lewis L, Maeder AJ. Factors influencing patient adherence to tuberculosis treatment in Ethiopia: a literature review. Int J Environ Res Public Health 2020;17:5626. 10.3390/ijerph17155626 - DOI - PMC - PubMed