Loss to follow-up among patients diagnosed with spinal tuberculosis at a tertiary hospital in Western Cape Province, South Africa : a retrospective cohort study

• Published in: South African medical journal 2020-04, Vol.110 (4), p.284-290
• Main Authors: Davis, J.H., Dyers, R., Mann, T.N.
• Format: Article
• Language: English
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2020.v110i4.14179

Background. Patients diagnosed with spinal tuberculosis (TB) at a major tertiary hospital in Western Cape Province, South Africa, are required to attend regular follow-up at the hospital’s outpatient spine clinic and to remain on TB treatment for at least 9 months. This followup and lengthy treatment is intended to allow for specialist monitoring of TB treatment response and early identification of secondary complications, and to reduce the risk of recurrence. However, little is known about adherence to these recommendations.Objectives. The main objectives were to describe (i) loss to spine clinic follow-up (LTFU), and (ii) TB treatment duration among patients diagnosed with spinal TB at the hospital. Secondary objectives were to investigate (i) the association between LTFU and treatment duration, and (ii) factors associated with LTFU.Methods. This retrospective cohort study included 173 adults diagnosed with spinal TB between 2012 and 2015 and investigated follow-up within 2 years from diagnosis. Clinical, demographic and appointment data were obtained from hospital records and a dataset provided by the provincial Department of Health. LTFU was presented as frequency (%) and as a survival analysis. TB treatment duration was reported as frequency Results. Patients had a median (interquartile range) age of 36 (29 - 48) years and included 98 females (57%) and 151 individuals (87%) residing Conclusions. Three-quarters of the patients did not complete follow-up at the tertiary hospital spine clinic, and almost one in three received