Factors Associated with Lost to Follow-up in New and Relapsed Pulmonary Tuberculosis Patients in Saraburi Province

Abstract

The objective of this research was to study the factors associated with loss to follow-up among new and relapsed pulmonary tuberculosis (TB) patients in Saraburi Province. The subjects were 344 new and relapsed TB patients registered during October 2016 – September 2019 in hospitals under Ministry of Public Health in Saraburi Province. The new and relapsed TB case record form was developed for the study. Descriptive statistics in the study included frequency, percentage, mean, median, standard deviation and rank. A chi-square test was performed to compare between TB cases with follow-up and loss to follow-up (significant level at 0.05). Odds ratios (OR) with 95% confidence intervals (95% CI) were presented. A multiple logistic regression analysis was then performed to determine factors associated with loss to follow-up TB cases after adjusting for other co-variables. Adjusted odds ratios () with 95% confidence intervals were presented in the results of analysis. Of 344 new and relapsed pulmonary TB cases, 76.7% were male, 21.5% were aged 45-54 year-old, 62.5% were unemployed, 66.3% had universal health insurance, 92.4% hadn’t co-morbid, 66.0% being TB contact, 29.7% had smear sputum 3+, 58.4% hadn’t lung cavity, 95.9% received standard drugs, and 63.4 were patients with no DOT. The multiple logistic regression analysis showed factors associated with loss to follow-up cases were aged ≤ 65 years old (5.059; 95% CI 1.199, 21.344),having body weight <35 kgs (106.795; 95% CI 32.572, 350.153), and having no cavity on chest X-ray (4.483; 95% CI 1.874, 10.725). Results from this study suggest that disease prevention and control workers should focus on Improve directly observation therapy (DOT) which will help reduce the loss to follow-up rate among new and relapsed pulmonary TB patients. Patients aged ≤ 65 years old, having body weight <35 kgs, and having no cavity in chest X-ray who have increased loss to follow-up should received much attention for TB case management.