Abstract
Loss to follow-up (LTFU) among pulmonary tuberculosis (PTB) patients is a significant challenge for TB control. However, there is a dearth of information about the factors leading to LTFU among marginalized communities. This study highlights the factors associated with LTFU in Saharia, a tribe of Madhya Pradesh having high tuberculosis (TB) prevalence. A qualitative study was carried out during January-April 2020 among twenty-two pulmonary TB patients, recorded as LTFU in NIKSHAY, with ten treatment supporters and ten patient's family members. Semi-structured personal interview tools were used to collect the information on the history of anti-tuberculosis treatment, adverse drug events (ADE), social cognitive, behaviors, myths, and misbeliefs. The interviews were transcribed and thematically analysed to examine underlying themes. The study explored various social, behavioral factors leading to loss to follow-up among PTB patients. Drug side effects, alcoholism, social stigma, lack of awareness of the seriousness of the diseases and poor counseling are the main barriers to treatment adherence in this community. The study highlights the need to address the issues related to LTFU during TB treatment. The enhanced efforts of treatment supporters, health staff, and family & community persons must motivate and support the patients.
Highlights
India is the highest tuberculosis (TB) burden country globally, accounting for about a quarter of the world’s TB cases [1]
The study explored various social, behavioral factors leading to loss to follow-up among pulmonary tuberculosis (PTB) patients
The study was carried out as a sub-study of the ongoing integrated TB control project (ITCP) in the Saharia population residing in seven districts of the Gwalior and Chambal divisions of Madhya Pradesh state in central India
Summary
India is the highest tuberculosis (TB) burden country globally, accounting for about a quarter of the world’s TB cases [1]. Poor compliance to tuberculosis treatment is a major obstacle for TB elimination programme as it can increase the risk of drug resistance and prolong infectiousness and may result in unfavourable outcomes such as treatment failure, death, and relapse, posing a public health threat [3, 4]. This is relevant for the tribal population, an underprivileged group of the society usually residing in remote rural areas, having poor access to the health delivery system. This study highlights the factors associated with LTFU in Saharia, a tribe of Madhya Pradesh having high tuberculosis (TB) prevalence
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