Factors associated with missed video directly observed therapy sessions among persons with TB

BACKGROUND Advanced digital technologies, such as video directly observed therapy (VDOT), are increasingly used to support TB treatment adherence monitoring. However, missed VDOT sessions remain a challenge, particularly in low-resource settings. This study aimed to determine the factors associated with the number of missed VDOT submissions among patients using VDOT. METHODS We conducted a secondary analysis of data from the DOT Selfie randomised controlled trial implemented in Uganda. The outcome of interest was the number of missed VDOT sessions throughout treatment. A negative binomial regression model was used to examine factors associated with the outcome. Incidence rate ratios (IRRs) and 95% confidence intervals were reported. RESULTS Among the 71 patients included in the analysis, 32% were HIV positive. HIV co-infection (cIRR = 2.2; 1.2-4.0), age >30 years (cIRR = 2.0; 1.1-3.6), alcohol consumption (aIRR = 2.3; 1.1-5.1), being married (aIRR = 2.2; 1.1-4.1), and having ≤4 household members (aIRR = 1.9; 1.1-3.3) were associated with a higher incidence rate of missed VDOT sessions. CONCLUSION In this study, alcohol use and HIV co-infection independently affected missed video sessions. However, after adjusting for confounding, marital status and household size remained important factors that should be further studied. .