Sharani et al reported the T-BACCO score to predict if a tuberculosis patient who smokes will be lost to follow-up. This can help to identify a patient requiring more aggressive management. The authors are from Universiti Teknologi MARA, affiliated hospitals, and government agencies in Malaysia.
Patient selection: adult (age > 18 years) with tuberculosis and a history of current smoking
Parameters:
(1) age in years
(2) ethnicity
(3) locality
(4) nationality
(5) education level
(6) individual monthly income in Ringgit Malaysia (0.212 USD)
(7) working status
(8) TB category
(9) TB detection
(10) X-ray status
(11) HIV status
(12) sputum status for acid-fast bacilli (AFB)
Parameter
Finding
Points
age in years
< 50 years
4
>= 50 years
0
ethnicity
Malay
0
Chinese
-6
Indian
2
other
0
locality
urban
7
rural
0
nationality
Malaysian
4
non-Malaysian
0
education level
no formal
10
primary school
6
secondary school
5
college or higher
0
individual income
<= 2,160 RM
6
> 2,160 RM
0
working status
not working
3
working
0
TB category
new case
0
previously treated
6
TB detection
passive
0
active
5
X-ray status
no or minimal lesions
0
moderate to severe lesion
3
HIV status
negative
0
positive
4
unknown
0
sputum status
positive
2
negative
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -6
• maximum score: 56
Total Score
Risk Category
Loss to Follow-Up
< 15
low
1-2%
15 to 25
medium
25%
> 25
high
48-75%
Performance:
• The area under the ROC curve is 0.68 in the derivation and 0.67 in the validation cohort.
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