Publication: Factors associated with non-initiation of tuberculosis preventive treatment among latent tuberculosis infection cases in Negeri Sembilan from 2022-2024
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Date
2025-06
Authors
Marimuthu, Sanggary
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Abstract
Background: Tuberculosis Preventive Treatment (TPT) is essential in reducing the risk of progression from latent tuberculosis infection (LTBI) to active disease. However, the factors associated with the non-initiation of TPT have not been explored thoroughly.
Objective: This study aimed to determine the proportion of LTBI patients who did not initiate TPT and to identify factors associated with non-initiation in Negeri Sembilan between 2022 and 2024.
Methodology: A retrospective cross-sectional study was conducted involving 757 LTBI cases reported from January 2022 to December 2024. Data were extracted from the National Tuberculosis Registry system using a universal sampling method and analysed with SPSS software. Univariable and multivariable logistic regression analyses were performed to determine the factors significantly associated with non-initiation of TPT.
Results: Overall, 9.3% of patients did not initiate TPT. Occupation emerged as a significant predictor; the “unemployed young” group (comprising students and
children under five) had significantly higher odds of non-initiation compared to professionals (aOR = 3.52; 95% CI: 1.35,9.16; p = 0.010). The district of residence was also influential, with patients from Tampin having five times the odds of not initiating TPT compared to those from Seremban (aOR = 5.12; 95% CI: 2.59,10.11; p < 0.01), while residence in Jempol had lower odds (aOR = 0.10; 95% CI: 0.01,0.74; p = 0.024). In addition, foreign nationals were significantly more likely not to initiate treatment compared to Malaysian citizens (aOR = 3.83; 95% CI:1.65,8.85; p = 0.020).
Conclusion: Occupation, nationality, and geographical location significantly influence the initiation of TPT among LTBI patients in Negeri Sembilan. These findings highlight the importance of centralised LTBI care, robust follow-up mechanisms, and tailored health education efforts to improve treatment uptake especially among high-risk group such as people living with HIV (PLHIV), contact of TB index cases, healthcare worker, prisoners and residents of nursing home.
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Keywords
Latent TB , TPT , factors