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  1. Suliman, Qudsiah, Salmiah Md. Said, Lim, Poh Ying
    MyJurnal
    The global Tuberculosis epidemic (TB) poses a significant public health threat. While the consequences of TB treatment interruption are indisputable, the knowledge about the timing and prognostic factors of TB treatment interruption is fundamental. Despite a considerable amount of evaluation, the timing and prognostic factors of TB treatment interruption have been inconsistently identified from one study to another. Therefore, this study aimed to examine the evidence obtained from published literature on the timing and prognostic factors of TB treatment interruption at different points of the treatment course. In this review, three databases namely Pubmed, Scopus, and Science Direct were used to identify articles published from January 2003 to February 2018. This was based on the inclusion criteria and keywords including ‘default’, ‘survival time’, ‘tuberculosis’, and ‘treatment interruption’. The nine selected studies were prospective and retrospective cohort studies conducted in developing countries. The diversity of the study’s participants and TB treatment interruption definition were allowed, thus delineating a heterogeneous finding. This review suggests that the interruption predominantly occurred during the maintenance phase of treatment course. Despite the finding, a considerable gap in understanding the prognostic factors at different time points of TB treatment interruption was elicited. The heterogeneity across the studies may limit the inferences and warrant further evaluation. In essence, the time-related information should be integrated into framing impactful public health strategy, while a vigorous attempt on the evaluation of the cognitive, behavioural and psychosocial aspects may be beneficial.
  2. Suliman Q, Lim PY, Md Said S, Tan KA, Mohd Zulkefli NA
    Sci Rep, 2022 01 14;12(1):745.
    PMID: 35031658 DOI: 10.1038/s41598-021-04742-2
    TB treatment interruption has resulted in delayed sputum conversion, drug resistance, and a high mortality rate and a prolonged treatment course, hence leading to economic and psychosocial affliction. To date, there are limited studies investigating the physico-social risk factors for early treatment interruptions. This prospective multicenter cohort study aimed to investigate the risk factors for early treatment interruption among new pulmonary tuberculosis (TB) smear-positive patients in Selangor, Malaysia. A total of 439 participants were recruited from 39 public treatment centres, 2018-2019. Multivariate Cox proportional hazard analyses were performed to analyse the risk factors for early treatment interruption. Of 439 participants, 104 (23.7%) had early treatment interruption, with 67.3% of early treatment interruption occurring in the first month of treatment. Being a current smoker and having a history of hospitalization, internalized stigma, low TB symptoms score, and waiting time spent at Directly Observed Treatment, Short-course centre were risk factors for early treatment interruption. An appropriate treatment adherence strategy is suggested to prioritize the high-risk group with high early treatment interruption. Efforts to quit smoking cessation programs and to promote stigma reduction interventions are crucial to reduce the probability of early treatment interruption.
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