Reasons for loss to follow-up (LTFU) of pulmonary TB (PTB) patients: A qualitative study among Saharia, a particularly vulnerable tribal group of Madhya Pradesh, India

PLoS One. 2021 Dec 23;16(12):e0261152. doi: 10.1371/journal.pone.0261152. eCollection 2021.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking
  • Female
  • Follow-Up Studies
  • Humans
  • India / epidemiology
  • Lost to Follow-Up
  • Male
  • Middle Aged
  • Mycobacterium / isolation & purification*
  • Prevalence
  • Qualitative Research
  • Risk Factors
  • Smoking
  • Socioeconomic Factors
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / microbiology
  • Tuberculosis, Pulmonary / therapy

Grants and funding

The study is financially supported by the Government of Madhya Pradesh (Budget 2210/2017-18/877 dated_27/01/18). However, the funding agency had no role in the study design, data collection, analyses, interpretation of results, reports & manuscript writing and submission to the journal.