Factors Associated with Loss to Follow Up among Tuberculosis Patients in Embu County, 2016-2021

Abstract

INTRODUCTION Loss of follow-up among Tuberculosis patients is a significant challenge for Tuberculosis control. It may lead to prolonged infectiousness of Tuberculosis cases, increased rate of treatment failure, relapse, progression to drug-resistant TB, and deaths. The study aimed at identifying factors associated with loss to follow-up among TB patients in Embu County. METHODOLOGY A retrospective cohort study was carried out among all patients (n = 8983) notified between the years 2016-2021 in Embu County, Kenya. The data was obtained from the routinely collected TB data stored in the National Tuberculosis Program database. Descriptive statistics and multivariate logistic regression were performed to identify factors associated with treatment loss to follow-up. Data analysis was conducted using R statistical software. RESULTS Out of 8,983 patients notified, 657(7.3%) of them had a treatment outcome of loss to follow-up. The majority were; males (78%), age groups 15-44 (68%), Embu West Sub County (67%), public sector (91%), clinically diagnosed (51%), obesity (30%), and the HIV positive (19%). Being a male (aOR=1.6(95% _CI: 1.3 – 1.9), being in age-group 15-44 years, being clinically diagnosed (aOR=1.58(95% _CI: 1.31– 1.92), being previously treated (aOR=1.38(95%_CI: 1.03-1.83), and having HIV as a comorbidity (aOR=1.48 (95%_CI: 1.19-1.83) increased the risk of being loss to follow up during TB treatment. CONCLUSION Loss to follow-up among TB patients is still a challenge in Embu County. Sex, age, and HIV status were shown to increase the risk of loss to follow-up among TB patients; thus highlighting the need for strategic interventions to improve treatment adherence.