Abstract:
Background: Tuberculosis (TB) remains a major public health problem throughout the world
particularly in resource limited countries. Ethiopia is among the top twenty high TB burden
countries. Loss to follow-up (LTFU) is one of the major obstacles in the fight against TB as it
presents serious implications for the patients, their families, and community who may become
infected with TB. There is limited data on proportion of LTFU and its associated factors among
adult TB patients treated at public health facilities in Warder district.
Objective: To assess LTFU and associated factors among adult TB patients treated from January
1, 2016 to December 31, 2020 at public health facilities in Warder District, Somali Region, East
Ethiopia from November 02-17,2021.
Methods: A five-year retrospective follow-up study was conducted on TB unit register of 589
adult TB patients. A systematic random sampling technique was used to recruit study
participants and structured data extraction format was used for data collection. Data was entered
and cleaned using EpiDATA version 3.02 and analyzed by STATA version 14.0 statistical
packages. Descriptive and analytical methods (bivariate and multivariate logistic regression)
were used to identify factors associated with the primary outcome of interest (LTFU) along with
calculation of PORs and AORs with 95%CI at P<0.05 statistical significance.
Results: Out of 589 TB patients included in this study, 221 (37.5%) were cured, 198 (33.6%)
completed treatment, 26 (4.4%) died, 9 (1.5%) failed treatment, and 35 (5.9%) were transferred out to another health facility. Ninety eight (16.6%) TB patients were LTFU. Age 55 to 64 years
(AOR 4.4, 95%CI 1.9-9.9), male sex (AOR 1.8, 95%CI 1.1-2.9), distance ≥10Km from public
health facility (AOR 4.9, 95%CI 2.5-9.4), and having past TB treatment history (AOR 2.3,
95%CI 1.2-4.4) were significantly associated to higher likelihood of LTFU while positive
baseline smear result (AOR 0.48, 95%CI 0.24-0.96) was associated to lower probability of
LTFU.
Conclusion: One out of six TB patients were LTFU after initiation of TB treatment in Warder
District. Patient’s clinical characteristics and distance to HF were significantly associated with
LTFU. Community identification and tracing of patients who discontinue their treatment with
special focus on the elderly, male patients, smear negative patients and retreatment cases is
crucial to reduce LTFU.
