Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)

Introduction: The number of TB/HIV co-infection reported in Malaysia is about eight percent of total HIV cases and about 5.9 percent of total notified TB cases. The proportion of the cases was decreased each year started in 2007. For more effective strategies of preventive, a model of TB/HIV shou...

Full description

Saved in:

Bibliographic Details
Main Author:	Yusof, Ruhana Che
Format:	Thesis
Language:	English
Published:	2016
Subjects:	RC306-320.5 Tuberculosis
Online Access:	http://eprints.usm.my/41303/1/Dr.__Ruhana_Che_Yusof-24_pages.pdf
Tags:	Add Tag No Tags, Be the first to tag this record!

id	my-usm-ep.41303
record_format	uketd_dc
spelling	my-usm-ep.413032019-04-12T05:25:33Z Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM) 2016 Yusof, Ruhana Che RC306-320.5 Tuberculosis Introduction: The number of TB/HIV co-infection reported in Malaysia is about eight percent of total HIV cases and about 5.9 percent of total notified TB cases. The proportion of the cases was decreased each year started in 2007. For more effective strategies of preventive, a model of TB/HIV should be developed especially compatible with Malaysia situation. Objectives: This study was proposed to model TB/HIV co-infection based on associated factors of anti TB treatment compliance and associated factors of TB treatment outcome and also predictor factors of mortality in TB/HIV co-infection and to assess the model using a new method known as a generalized structural equation model. Methodology: Retrospective cohort study had extracted out information such as socio-demographic, social and medical history, signs and symptoms at diagnosis and treatment from 284 medical records from 2005 to 2012 in two selected government hospitals. Multiple logistic regression was applied in two analyses; determination of associated factors in ATT compliance and associated factors in the ATT outcome. Meanwhile, Cox regression was used in determining predictor factors of mortality. All outcomes were combined together and latent variable of TB diagnosis was added to determine the TB/HIV co-infection model using generalized structural equation modeling. The mediating effect also was assessed in the model. Results: The model had identified three significant associated factors of ATT compliance (hepatitis, age of diagnosis TB and history of previous TB), five significant factors of success in TB treatment (CD4 count, area of residency, ATT compliance, ATT duration and received HAART) and five significant predictor factors of mortality (ATT outcome, MOT sexual, MOT IVDU, received HAART, ATT duration) included one time varying covariate variable (area of residency). The latent TB diagnosis variable was significantly measured by symptoms of cough, fever, night sweating, loss of weight and laboratory findings (chest x-ray, sputum AFB smear and culture). The combination of all outcomes of the analyses simultaneously by a new method gave a similar result as traditional methods with advances in increments of a latent variable added. ATT outcome was suspected to mediate the effect of ATT compliance to mortality. Conclusion: Development of generalized structural equations modeling to analyze simultaneously many outcomes of different distributions with the addition of latent variables at the same time can benefit many researchers to validate their models. However, the method was still in early development and has many limitations need to improve by the software developer. 2016 Thesis http://eprints.usm.my/41303/ http://eprints.usm.my/41303/1/Dr.__Ruhana_Che_Yusof-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC306-320.5 Tuberculosis
spellingShingle	RC306-320.5 Tuberculosis Yusof, Ruhana Che Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)
description	Introduction: The number of TB/HIV co-infection reported in Malaysia is about eight percent of total HIV cases and about 5.9 percent of total notified TB cases. The proportion of the cases was decreased each year started in 2007. For more effective strategies of preventive, a model of TB/HIV should be developed especially compatible with Malaysia situation. Objectives: This study was proposed to model TB/HIV co-infection based on associated factors of anti TB treatment compliance and associated factors of TB treatment outcome and also predictor factors of mortality in TB/HIV co-infection and to assess the model using a new method known as a generalized structural equation model. Methodology: Retrospective cohort study had extracted out information such as socio-demographic, social and medical history, signs and symptoms at diagnosis and treatment from 284 medical records from 2005 to 2012 in two selected government hospitals. Multiple logistic regression was applied in two analyses; determination of associated factors in ATT compliance and associated factors in the ATT outcome. Meanwhile, Cox regression was used in determining predictor factors of mortality. All outcomes were combined together and latent variable of TB diagnosis was added to determine the TB/HIV co-infection model using generalized structural equation modeling. The mediating effect also was assessed in the model. Results: The model had identified three significant associated factors of ATT compliance (hepatitis, age of diagnosis TB and history of previous TB), five significant factors of success in TB treatment (CD4 count, area of residency, ATT compliance, ATT duration and received HAART) and five significant predictor factors of mortality (ATT outcome, MOT sexual, MOT IVDU, received HAART, ATT duration) included one time varying covariate variable (area of residency). The latent TB diagnosis variable was significantly measured by symptoms of cough, fever, night sweating, loss of weight and laboratory findings (chest x-ray, sputum AFB smear and culture). The combination of all outcomes of the analyses simultaneously by a new method gave a similar result as traditional methods with advances in increments of a latent variable added. ATT outcome was suspected to mediate the effect of ATT compliance to mortality. Conclusion: Development of generalized structural equations modeling to analyze simultaneously many outcomes of different distributions with the addition of latent variables at the same time can benefit many researchers to validate their models. However, the method was still in early development and has many limitations need to improve by the software developer.
format	Thesis
qualification_level	Master's degree
author	Yusof, Ruhana Che
author_facet	Yusof, Ruhana Che
author_sort	Yusof, Ruhana Che
title	Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)
title_short	Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)
title_full	Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)
title_fullStr	Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)
title_full_unstemmed	Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)
title_sort	factors associated with anti tuberculosis therapy (att) compliance, att outcomes and survival of patients with tb/hiv co-infection using generalized structural equation modeling (gsem)
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2016
url	http://eprints.usm.my/41303/1/Dr.__Ruhana_Che_Yusof-24_pages.pdf
_version_	1747820906224287744

Factors associated with anti tuberculosis therapy (ATT) compliance, ATT outcomes and survival of patients with TB/HIV co-infection using generalized structural equation modeling (GSEM)

Similar Items