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Volume 22, Number 3—March 2016

Factors Associated with Loss to Follow-up during Treatment for Multidrug-Resistant Tuberculosis, the Philippines, 2012–2014

Thelma E. TupasiComments to Author , Anna Marie Celina G. Garfin, Ekaterina V. Kurbatova, Joan M. Mangan, Ruth Orillaza-Chi, Leilani C. Naval, Glenn I. Balane, Ramon Basilio, Alexander Golubkov, Evelyn S. Joson, Woo-jin Lew, Vivian Lofranco, Mariquita Mantala, Stuart Pancho, and Jesus N. Sarol
Author affiliations: Tropical Disease Foundation, Inc., Makati City, the Philippines (T.E. Tupasi, L.C. Naval, G.I. Balane, E.S. Joson, J.N. Sarol Jr.); Department of Health, Manila, the Philippines (A.M.C.G. Garfin, R. Basilio); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E.V. Kurbatova, J.M. Mangan); Philippine Business for Social Progress–Innovations and Multisectoral Partnership to Achieve Control of Tuberculosis Project, Manila (R. Orillaza-Chi); US Agency for International Development (USAID), Washington, DC, USA (A. Golubkov); World Health Organization Philippines, Manila (W.-j. Lew); The Lung Center of the Philippines, Manila (V. Lofranco, S. Pancho); Technical Assistance to the Countries–USAID-funded activity, Manila (M. Mantala)

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Table 1

Calculation of summary scores in study of loss to follow-up during treatment for multidrug-resistant TB, the Philippines, 2012–2014*

Score type Score calculation Score interpretation
General TB knowledge, including understanding of severity of the disease and susceptibility to the disease
Participants were asked 15 questions that focused on 1) the severity of the TB problem in their community, 2) TB transmission and morbidity/mortality, and 3) TB treatment. Each item answered correctly was awarded 1 point. Incorrect answers or “Not sure” responses received 0 points. The summary score was extrapolated onto a scale of 100 and reported as a percentage by using the following formula: General TB knowledge score = (total points earned/15) × 100 (i.e., score is calculated on a scale of 0–100%).
A higher score may indicate greater TB knowledge and greater perceived severity and susceptibility to the disease.
Expectations related to TB and its treatment
Participants were asked 5 interview questions aimed at determining their concerns for passing TB to loved ones, relapsing, and developing worsening drug resistance. Possible range of scores 5–15.
A higher score may indicate greater concerns or an expectation that TB could cause problems in the future. In addition to factors such as knowledge, attitudes, and beliefs, expected outcomes can determine a person’s actions. These expectations may be derived from 1) previous experiences, 2) observing or hearing about others in similar situations, 3) persuasive conversations, or 4) emotional or physical responses.
Self-efficacy (or confidence) to adhere to treatment at the time treatment was about to begin
Eight interview questions were included in the self-efficacy questionnaire. “Very confident” = 3 points, “A little confident” = 2 points, “unsure” = 1 point, and “I knew I could not do this” = 0 points. The score for each item would be added together to calculate a cumulative self-efficacy score. Possible range of scores 0–24 points.
A higher score may indicate a high degree of self-reported self-efficacy for adhering to treatment regimen, coping with the treatment, and meeting with DOT staff when about to start treatment.
Social support from family and friends
Score was based on responses to 3 interview questions with possible range of scores 3–15.
Lower scores may indicate less support.
Trust in, rapport with, and support from physicians and nursing staff
An overall score was based on 22 items grouped together. Possible range of scores 22–110.
A higher score may indicate a greater level of trust, rapport, and perceived support. Items were separated by topic, and separate scores were also calculated for participants’ 1) trust in, and rapport with physicians (13 questions); 2) trust in, and rapport with nurses (5 questions); and 3) perceived support from health center staff (4 questions).
Patient self-stigmatization A cumulative score for stigma was based on 2 interview questions. Possible range of scores 1–10. A higher score may indicate less stigma.

*DOTS, directly observed therapy; TB, tuberculosis.

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Page created: February 18, 2016
Page updated: February 18, 2016
Page reviewed: February 18, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.