Table 2.
Individual-level risk factors for default from treatment among non-MDR-TB cases in new and previously treated TB cases in Moldova for TB cases diagnosed between 2007 and 2010. Results from univariable and multivariable models are presented. Cells left blank indicate that that variable was not included in the multivariable model.
| New TB cases | Previously treated TB cases | |||||||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| Univariable model results | Multivariable model results | Univariable model results | Multivariable model results | |||||
|
| ||||||||
| Variable | Hazard ratio (95% CI§) | P-value | Hazard ratio (95% CI§) | P-value | Hazard ratio (95% CI§) | P-value | Hazard ratio (95% CI§) | P-valu |
| Living in an urban or rural area | ||||||||
| Rural | Ref | Ref | ||||||
| Urban | 1.31 (1.07, 1.60) | 0.008 | 1.36 (1.06, 1.75) | 0.015 | ||||
| Homeless | ||||||||
| No | Ref | Ref | Ref | |||||
| Yes | 3.56 (2.61, 4.84) | <0.0001 | 2.33 (1.64, 3.29) | <0.0001 | 1.50 (0.96, 2.36) | 0.074 | ||
| Gender | ||||||||
| Female | Ref | Ref | ||||||
| Male | 1.29 (1.00, 1.66) | 0.046 | 1.31 (0.89, 1.92) | 0.17 | ||||
| Citizenship | ||||||||
| Moldovan | Ref | Ref | Ref | |||||
| Other | 3.21 (1.33, 7.75) | 0.010 | 0.00 (0.00, >100) | 0.98 | 0.00 (0.00, >100) | 0.99 | ||
| Occupation | ||||||||
| Employed/retired/disabled | Ref | Estimates varied by time# | Ref | Ref | ||||
| Student | 0.28 (0.07, 1.16) | 0.080 | 1.79 (0.43, 7.40) | 0.42 | 1.94 (0.40, 9.37) | 0.41 | ||
| Unemployed | 2.62 (1.98, 3.46) | <0.0001 | 2.19 (1.56, 3.09) | <0.0001 | 2.18 (1.00, 4.79) | 0.051 | ||
| Salaried | ||||||||
| Yes | Ref | Ref | Ref | |||||
| No | 2.46 (1.85, 3.27) | <0.0001 | 2.13 (1.49, 3.04) | <0.0001 | 1.07 (0.47, 2.43) | 0.86 | ||
| Education (linear) | ||||||||
| For each increase in education level† | 0.72 (0.63, 0.83) | <0.0001 | 0.77 (0.66, 0.91) | 0.002 | 0.73 (0.61, 0.88) | 0.0009 | 0.80 (0.65, 1.00) | 0.046 |
| Spent >3 months outside Moldova during previous 12 months | ||||||||
| No | Ref | Ref | Ref | |||||
| Yes | 1.26 (1.00, 1.59) | 0.054 | 1.29 (0.91, 1.83) | 0.15 | 1.55 (1.06, 2.27) | 0.025 | ||
| Was previously in detention | ||||||||
| No | Ref | Ref | Ref | Ref | ||||
| Yes | 1.54 (1.14, 2.08) | 0.005 | 1.28 (0.91, 1.80) | 0.16 | 1.72 (1.28, 2.33) | 0.0005 | 1.68 (1.18, 2.39) | 0.004 |
| In detention at the time of diagnosis | ||||||||
| No and did not go into detention during treatment | Ref | Ref | Ref | Ref | ||||
| No but went into detention during treatment | 1.86 (0.46, 7.50) | 0.38 | 1.00 (0.24, 4.21) | 0.99 | 0.00 (0.00, >100) | 0.99 | 0.00 (0.00, >100) | 0.99 |
| Yes and remained there throughout treatment | 0.16 (0.04, 0.64) | 0.010 | 0.04 (0.01, 0.33) | 0.002 | 0.00 (0.00, >100) | 0.97 | 0.00 (0.00, >100) | 0.98 |
| Yes and was released during treatment | 5.73 (2.96, 11.09) | <0.0001 | 2.04 (0.89, 4.67) | 0.096 | 1.48 (0.37, 5.95) | 0.58 | 0.67 (0.14, 3.09) | 0.60 |
| Household size | ||||||||
| Living with others | Ref | Ref | Ref | Ref | ||||
| Living alone | 1.73 (1.39, 2.16) | <0.0001 | 1.57 (1.20, 2.04) | 0.0008 | 1.30 (1.00, 1.70) | 0.048 | 1.35 (0.98, 1.86) | 0.064 |
| Number of children in the household | ||||||||
| None | Ref | Ref | Ref | |||||
| At least one | 1.30 (1.05, 1.60) | 0.017 | 1.06 (0.80, 1.40) | 0.70 | 0.54 (0.30, 0.96) | 0.032 | ||
| Lives with someone with diagnosed TB | ||||||||
| No | Ref | Ref | Ref | |||||
| Yes | 1.27 (0.87, 1.85) | 0.22 | 0.86 (0.55, 1.37) | 0.53 | 1.54 (1.19, 1.99) | 0.001 | ||
| Degree of lung pathology | ||||||||
| Infiltration | Ref | Ref | Ref | |||||
| Destruction | 1.70 (1.36, 2.12) | <0.0001 | 1.59 (1.25, 2.02) | 0.0002 | 1.45 (1.08, 1.95) | 0.014 | ||
| Smear microscopy result | ||||||||
| Negative/untested/result unknown | Ref | Ref | ||||||
| Positive | 1.19 (0.96, 1.48) | 0.12 | 1.36 (0.98, 1.88) | 0.067 | ||||
| Culture positivity (linear, graded 1–3) | ||||||||
| For each increase in grade | 1.02 (0.90, 1.16) | 0.72 | 1.11 (0.95, 1.31) | 0.19 | ||||
| HIV status | ||||||||
| Negative | Ref | Ref | Ref | |||||
| Positive/untested/result unknown | 1.68 (1.31, 2.15) | <0.0001 | 1.55 (1.17, 2.05) | 0.002 | 1.27 (0.91, 1.77) | 0.16 | ||
| Presence of resistance to first line drugs at baseline (linear)* | ||||||||
| Each additional drug | 1.26 (1.11, 1.44) | 0.0005 | 1.27 (1.10, 1.46) | 0.001 | 1.03 (0.88, 1.21) | 0.71 | ||
| Age (years) | ||||||||
| < 30 | Ref | Ref | ||||||
| 30–39 | 1.44 (1.12, 1.86) | 0.005 | 1.20 (0.80, 1.78) | 0.38 | ||||
| ≥ 40 | 0.85 (0.67, 1.08) | 0.19 | 0.81 (0.56, 1.17) | 0.27 | ||||
| Region of residence¶ | <0.0001 | <0.0001 | 0.056 | 0.11 | ||||
Categories in increasing order: No education, primary, secondary, specialized secondary, higher;
CI=Confidence Interval;
Region of residence has 45 levels therefore we are presenting the p-value for the statistical significance of the entire variable (from a likelihood ratio test), Figure 3 shows a map of the default rates by region of residence,
These parameter estimates varied significantly by time; students were less likely than all other occupation categories to default and unemployed people were more likely to default although estimated hazard ratios varied by time on treatment (Supplementary Table S4),
A full breakdown of resistance profiles is shown in Supplementary Table S3