Early Hospital Readmission in Patients With Tuberculosis: Social and Cultural Risk Factors

Author(s): Diana M. Valenzuela-Soltero, Jesús A. Güereca-Alvarado, Murielle Pacheco-Barajas, Nathaly Sánchez-Rebollar, Rafael Laniado-Laborín*

Journal Name: Current Respiratory Medicine Reviews

Volume 16 , Issue 1 , 2020

Become EABM
Become Reviewer

Graphical Abstract:


Background: Few studies have focused on risk factors for early readmission in patients with tuberculosis.

Objective: Determine what are the risk factors for the early readmission of patients with tuberculosis at General Tijuana Hospital, Mexico.

Materials and Methods: All patients aged ≥ 18 years who were admitted with the confirmed diagnosis of pulmonary tuberculosis were prospectively included. Information was obtained on demographic, socioeconomic variables, previous hospitalizations, clinical data, and laboratory and radiographic studies.

Results: One hundred and thirty-four patients with tuberculosis were included, and 24 of them (17.9%) corresponded to early hospital readmissions. The interval between initial admission and readmission was 1.45 ± 0.183 months. The readmission group had used illicit drugs for more years (11.3 ± 13.9 years) than the new cases group (8.01 ± 8.25 years; p = 0.03). Forty percent of the patients who were readmitted did not go to their referral health unit after their initial hospital discharge. The reasons argued by the patients included, among others, not having received information regarding their illness during hospitalization, the abuse of illegal substances and the perception of hostility by health personnel.

Discussion: One out of every five patients admitted for tuberculosis will be readmitted after only six weeks of initial discharge. Sociocultural factors (addictions, comorbidities, poverty) and of the health system (limited hours of medical care, accessibility) contribute to this phenomenon.

Conclusion: Loss of follow-up after hospital discharge is common in most settings and contributes to an increase in morbidity and mortality, and transmission of infection in the community.

Keywords: Factors, hospital, readmission, socioeconomic, substance abuse, tuberculosis.

Global tuberculosis report 2019 Geneva: World Health Organization; 2019.Licence: CC BY-NC-SA 30 IGO .
World Health Organization tuberculosis country profiles 2019..Available from: https://www.who.int/tb/country/data/profiles/en/
Fuente: Plataforma Única de Información/SUIVE/DGE/SS CONAPO Proyección 2010-2050 2016.Cierre CUBOS/DGIS Available from: http://www.cenaprece.salud.gob.mx/programas/interior/micobacteriosis/descargas/pdf/RutaEliminacionTBNivelSubnacional.pdf
Abarca Tomás B, Pell C, Bueno Cavanillas A, Guillén Solvas J, Pool R, Roura M. Tuberculosis in migrant populations. A systematic review of the qualitative literature. PLoS One 2013; 8(12): e82440
[http://dx.doi.org/10.1371/journal.pone.0082440] [PMID: 24349284]
Baja California Gobierno del Estado. Strategic diagnosis Characteristics of the population of Baja California [cited: 17 August 2018]. .Available from: http://www.bajacalifornia.gob.mx/portal/gobierno/ped/doctos/diagnostico_estrategico.pdf
Reyes-Guillén I, Sánchez-Pérez HJ, Cruz-Burguete J, Izaurieta-de Juan M. Anti-tuberculosis treatment defaulting: an analysis of perceptions and interactions in Chiapas, Mexico. Salud Publica Mex 2008; 50(3): 251-7.
[PMID: 18516373]
Shamaei M, Samiei-Nejad M, Nadernejad M, Baghaei P. Risk factors for readmission to hospital in patients with tuberculosis in Tehran, Iran: three-year surveillance. Int J STD AIDS 2017; 28(12): 1169-74.
[http://dx.doi.org/10.1177/0956462417691442] [PMID: 28166697]
Franke MF, Appleton SC, Bayona J, et al. Risk factors and mortality associated with default from multidrug-resistant tuberculosis treatment. Clin Infect Dis 2008; 46(12): 1844-51.
[http://dx.doi.org/10.1086/588292] [PMID: 18462099]
Torres GZ, Herrera MT. Tuberculosis treatment default: profile of patients in Chile. Rev Chil Enferm Respir 2015; 31: 52-7.
Arenas NE, Quintero-Álvarez L, Rodríguez-Marín K, Gómez-Marín JE. Análisis sociodemográfico y espacial de la transmisión de la tuberculosis en la ciudad de Armenia (Colombia). Infectio 2012; 16: 154-60.
Garfein RS, Laniado-Laborin R, Rodwell TC, et al. Latent tuberculosis among persons at risk for infection with HIV, Tijuana, Mexico. Emerg Infect Dis 2010; 16(5): 757-63.
[http://dx.doi.org/10.3201/eid1605.091446] [PMID: 20409363]
Tola HH, Shojaeizadeh D, Tol A, et al. Psychological and educational intervention to improve tuberculosis treatment adherence in ethiopia based on health belief model: a cluster randomized control trial. PLoS One 2016; 11(5): e0155147
[http://dx.doi.org/10.1371/journal.pone.0155147] [PMID: 27167378]
Guidelines for treatment of drug-susceptible tuberculosis and patient care, 2017.update Geneva: World Health Organization; 2017 Licence: CC BY-NC-SA 30 IGO .
Ngwatu BK, Nsengiyumva NP, Oxlade O, et al. Collaborative group on the impact of digital technologies on TB. The impact of digital health technologies on tuberculosis treatment: a systematic review. Eur Respir J 2018; 51(1): 1701596
[http://dx.doi.org/10.1183/13993003.01596-2017] [PMID: 29326332]

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2020
Published on: 15 September, 2020
Page: [54 - 58]
Pages: 5
DOI: 10.2174/1573398X16999200531170451
Price: $65

Article Metrics

PDF: 13