Magnitude and factors associated with pre-diagnosis loss to follow-up among tuberculosis presumptive patients in the Cycle of Health Care, Musoma, Tanzania: Cross-sectional study

Abstract

Background: Despite National Tuberculosis (TB) Program efforts on tuberculosis control in the country, pre-diagnosis loss to follow-up is still a major problem. The study aims at exploring the magnitude and risk factors of presumptive TB cases who either do not submit a second sputum sample or do not show up for their laboratory results. Methods: The study included presumptive TB registered at the Musoma Regional Referral Hospital between May and November 2014. Lost to follow up presumptive TB were then traced and interviewed from December 2014 to April 2015. One hundred and thirty-two among those who submitted both samples and showed up for their results were randomly selected as a comparison group. Results: A total of 620 presumptive TB was registered at the Musoma Regional Referral Hospital of which 521 (84.0%) completed TB testing in accordance with the national TB diagnostic algorithm while 99 (16.0%) did not complete. Out of those who did not complete, 65 (65.7%) submitted only one spot sample and 34 (34.3%) submitted both but all of these did not pick-up their results. The Mean age of participants was 45.3 years. The main reasons for loss to follow-up were: 23 (23.2%) opted to go to other health care facilities; 23 (23.2%) lack of transport fare; and 20 (20.2%) long distance to the hospital. Males were 1.6 more likely to complete TB diagnostic algorithm. Conclusions: The magnitude of TB pre-diagnosis loss is very high. Lack of transport fare and long distance to healthcare facilities were the main reasons. Active tracing of pre-diagnosis loss to follow up to presumptive TB individuals to bring them back to care is highly recommended.