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Home / The International Journal of Tuberculosis and Lung Disease, Volume 20, Number 10

Loss to follow-up among adolescents with tuberculosis in Gaborone, Botswana

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SETTING: Nine high-burden public tuberculosis (TB) clinics in Gaborone, Botswana.

OBJECTIVE: To describe clinical characteristics and outcomes among adolescents with TB and compare loss to follow-up (LTFU) rates with that among youth and adult cases.

DESIGN: Retrospective cohort study of TB cases registered from 2012 to 2014. Clinical characteristics and treatment outcomes were compared among adolescents (age 10–19 years), youth (20–24 years) and a systematic sample of adults (25 years).

RESULTS: We analyzed 120 adolescent, 210 youth, and 548 adult cases. Adolescents had twice the risk of LTFU over adults (RR 2.0, 95%CI 1.1–3.7, P = 0.03), and higher LTFU than youth; this was not significant (RR 1.4, 95%CI 0.7–2.9, P = 0.32). Of those with human immunodeficiency virus (HIV) infection, 8/35 (22.9%) adolescents were LTFU, compared with 3/51 (5.9%) youth, and 25/407 (6.1%) adults (P = 0.001). In a multivariable model, adolescence (OR 3.0, 95%CI 1.3–6.5, P < 0.01), HIV positivity (OR 2.2, 95%CI 1.1–4.5, P = 0.02), and extra-pulmonary TB (OR 2.2, 95%CI 1.2–4.0, P = 0.01) were each associated with LTFU.

CONCLUSION: Adolescents treated for TB had greater LTFU than youth and adults, particularly in the setting of TB-HIV coinfection. Further work should clarify the generalizability of these findings and investigate poor outcomes among adolescents with TB.

Keywords: Africa; HIV; TB; default; pediatric

Document Type: Research Article

Affiliations: 1: Division of Infectious Diseases, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana 2: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana, Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA 3: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana 4: Botswana-UPenn Partnership, Gaborone, Botswana 5: Division of Infectious Diseases, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; 6: Botswana National TB Programme, Ministry of Health, Gaborone, Botswana 7: Division of Infectious Diseases and, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

Publication date: 01 October 2016

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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