Survival Status and Predictors of Loss to Follow-up Among Adult Patients with Tuberculosis on Follow-up and Care in Public Health Facilities of Sheka Zone, South-West Ethiopia: Facility-Based, Retrospective Cohort Study

Abstract

Background: Treatment success rate and loss to follow-up (LTFU) in patient with tuberculosis (TB) are a great concern in Ethiopia. However, available information is inadequate to assess the magnitude of LTFU and its predictors in geographically remote regions of Ethiopia. Objectives: The current study aimed at assessing the survival status and predictors of LTFU among adult patients with tuberculosis registered in TB treatment and care center in public health institutions of Sheka Zone, South-West Ethiopia. Methods: A facility-based, retrospective cohort study was conducted from 01 to 30 August 2016. The LTFU was defined as patient with tuberculosis under follow-up being lost before treatment initiation or treatment interruption for two or more successive months. Kaplan-Meir curve and Cox proportional hazard model were fitted to determine survival time and predictors with survival status, respectively. Results: A total of 1319 patients with tuberculosis were followed up for a total of 7056.87 months from treatment initiation to outcomes. Of these, 117 (8.9%) patients were lost. The survival status at the completion of the intensive and continuation phases was 93.7% and 90%, respectively. Living farther than 10 Km away from the nearest health facility (adjusted odds ratio (AHR) = 4.9, 95% confidence interval (CI): 3.02 - 12.50) and not being adhered to anti-retroviral therapy (AHR = 5.3, 95%CI: 1.63 - 8.12) were significantly associated with LTFU. Conclusions: Significant TB patient LTFU was observed during the first two months of treatment and care. LTFU was high in patients not adhered to antiretroviral therapy (ART) and living far.