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Tuberculosis-related knowledge is associated with patient outcomes in shantytown residents; results from a cohort study, Peru

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dc.contributor.author Westerlund, Emma E.
dc.contributor.author Tovar, Marco A.
dc.contributor.author Lonnermark, Elisabet
dc.contributor.author Montoya, Rosario
dc.contributor.author Evans, Carlton A.
dc.date.accessioned 2019-02-06T14:57:40Z
dc.date.available 2019-02-06T14:57:40Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5486
dc.description.abstract OBJECTIVES: Tuberculosis is frequent among poor and marginalized people whose limited tuberculosis-related knowledge may impair healthcare access. We characterised tuberculosis-related knowledge and associations with delayed treatment and treatment outcome. METHODS: Tuberculosis patients (n = 943), people being tested for suspected tuberculosis (n = 2020), and randomly selected healthy controls (n = 476) in 16 periurban shantytowns were interviewed characterizing: socio-demographic factors; tuberculosis risk-factors; and patients' treatment delay. Principle component analysis was used to generate a tuberculosis-related knowledge score. Patients were followed-up for median 7.7 years. Factors associated with tuberculosis treatment delay, treatment outcome and tuberculosis recurrence were assessed using linear, logistic and Cox regression. RESULTS: Tuberculosis-related knowledge was poor, especially in older people who had not completed schooling and had never been diagnosed with tuberculosis. Tuberculosis treatment delay was median 60 days and was more delayed for patients who were poorer, older, had more severe tuberculosis and in only unadjusted analysis with incomplete schooling and low tuberculosis-related knowledge (all p </= 0.03). Lower than median tuberculosis-related knowledge was associated with tuberculosis recurrence (unadjusted hazard ratio = 2.1, p = 0.008), and this association was independent of co-morbidities, disease severity and demographic factors (multiple regression adjusted hazard ratio = 2.6, p = 0.008). CONCLUSIONS: Low tuberculosis-related knowledge independently predicted tuberculosis recurrence. Thus health education may improve tuberculosis prognosis. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof urn:issn:1532-2742
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Follow-Up Studies en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Mycobacterium tuberculosis en_US
dc.subject Cohort Studies en_US
dc.subject Surveys and Questionnaires en_US
dc.subject Treatment Outcome en_US
dc.subject Age Factors en_US
dc.subject Multivariate Analysis en_US
dc.subject Health Services Accessibility en_US
dc.subject Health Knowledge, Attitudes, Practice en_US
dc.subject Poverty en_US
dc.subject Principal Component Analysis en_US
dc.subject Recurrence en_US
dc.subject Clinical outcome en_US
dc.subject Patient Acceptance of Health Care/psychology/statistics & numerical data en_US
dc.subject Proportional Hazards Models en_US
dc.subject Tuberculosis knowledge en_US
dc.subject Tuberculosis/diagnosis/epidemiology/prevention & control/therapy en_US
dc.title Tuberculosis-related knowledge is associated with patient outcomes in shantytown residents; results from a cohort study, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.jinf.2015.05.010
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08


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