Bulletin of the World Health Organization

Pre-treatment loss to follow-up in tuberculosis patients in low- and lower-middle-income countries and high-burden countries: a systematic review and meta-analysis

Peter MacPherson, Rein MGJ Houben, Judith R Glynn, Elizabeth L Corbett & Katharina Kranzer

Volume 92, Number 2, February 2014, 126-138

Table 2. Characteristics of studies included in the review and proportion of smear-positive tuberculosis patients who initiated treatment

Study  Year(s) study conducted Country Setting Diagnostic criterion Recruitment period No. with diagnosis of tuberculosis Follow-up period Temporal definition of pre-treatment loss to follow-up Method used to confirm start of treatment No. (%) of patients initiating treatment
Creek, 200027 1997 Botswana Gaborone, outpatient department of public hospital and 13 PHCs ≥ 1 positive smear 5 months 184 5–22 months 2 weeks Retrospective linking of laboratory register and national electronic tuberculosis register 165 (90)
Dembele, 200628 2001 Burkina Faso 6 districts (including the capital) Any smear positive 1 year 31 NR ND Retrospective linking of laboratory and treatment registers 27 (87)
Afutu, 201221 2009 Ghana Regional hospital Smear positive not further specified 1 year 84 9–27 months ND Retrospective linking of laboratory and treatment registers 52 (62)
Glynn, 199830 1986–1994 Malawi Rural PHCs, one district hospital ≥ 1 positive smear 90 months 682 Up to 110 months ND Prospective monthly follow-up as part of Demographic and Health Survey 642 (94)
Nyirenda, 199832 1997 Malawi National Smear positive, not further specified 6 months 3482 2–8 monthsa ND Retrospective linking of laboratory and treatment registers 2980 (86)
Squire, 200510 2000 Malawi Rural, 31 PHCs, one district hospital Smear positive, not further specified 6 months 157 0–6 months ND Retrospective linking of laboratory and treatment registers; home tracing of patients with missing treatment information 134 (85)
Uchenna, 201236 2009 Nigeria 5 states in southern Nigeria Smear positive, not further specified 3 months 323 Up to 3 months 2 days Retrospective collation of total number of tuberculosis patients diagnosed in laboratory registers and treated in treatment registers (individual records not linked) 268 (83)
Botha, 200823 2004–2005 South Africa 13 PHCs ≥ 2 positive smears 1 year 367 3–15 months 3 months Retrospective linking of sputum collection register and treatment register 303 (83)
Botha, 200824 2005 South Africa 11 PHCs in the Western Cape province (8 in Cape Town metropolitan area) ≥ 2 positive smears 3 months 227 4–16 months 2 months Retrospective linking of laboratory and treatment registers 203 (89)
Claassens, 201037 2009 South Africa 133 PHCs in 5 provinces Smear positive, not further specified 5 months 3020 NR 1 month Retrospective linking of laboratory and treatment registers 2268 (75)
Dunbar, 201129 2007 South Africa Two community clinics Bacteriologically confirmed 1 year 306 Up to 24 monthsb 2 months Retrospective linking of laboratory and treatment registers 243 (79)
Davis, 201141 2009 Uganda Five PHCs ≥ 1 positive smear 1 year 81 NR ND Prospective cohort follow-up, with additional retrospective linkage of laboratory and treatment registers for confirmation 62 (77)
Chadambuka, 201126 2006 Zimbabwe Gokwe district Smear positive, not further specified 1 year 112 1 month ND Retrospective linking of laboratory and treatment registers/”stock cards” 82 (73)
Balasubramanian, 200422 1998–2001 India PHCs ≥ 2 positive smears 2 years 833 3 months 3 months Retrospective linking of laboratory register and patient records 713 (86)
Gopi, 200531 2001–2003 India One PHC Smear positive, not further specified 31 months 1049 2 months 2 months Prospective reconciliation of laboratory and treatment registers 893 (85)
Sai Babu, 200834 2006 India 20 districts in Andhra Pradesh state ≥ 2 positive smears 3 months 15 361 Cross-sectional: identification of all initial defaulters in one quarter of 2006 ND Extraction of data from laboratory register; home tracing of patients with missing treatment information 14 676 (96)
Razia, 201139 2009 Pakistan One district, including 16 peripheral centres and five tertiary centres Smear positive, not further specified 1 year 1698 Up to one year ND Retrospective linking of laboratory and treatment registers 1597 (94)
Rao, 200933 2007–2008 Pakistan Chest clinic, Karachi Smear positive, not further specified 5 months 224 Patients prospectively recruited during a 5-month period; time before tracing undertaken not defined ND Telephone tracing of patients who did not return for treatment 162 (72)
Rao, 201140 2010 Pakistan Chest clinic, Karachi Smear positive, not further specified 6-months 1121 Up to 6 months ND Telephone tracing of patients who did not return for treatment 947 (84)
Korobitsyn, 201038 2008–2009 Tajikistan Four districts Smear positive, not further specified 1 year 254 Up to one year ND Retrospective linking of laboratory and treatment registers 209 (82)
Uthaivoravit, 200335 1995 Thailand Provincial referral hospital ≥ 1 positive smear 60 months 212 “Mid-1996” to “the end of 2000”. Reported in yearly cohorts ND Prospective linking of laboratory, treatment register and medical records 168 (79)
Buu, 200325 2000 Viet Nam District tuberculosis units ≥ 1 positive smear 1 year 4208 1 month 1 month Retrospective linking of laboratory and treatment registers 3859 (92)
Ram, 201242 2001–2010 Fiji 4 laboratories and 2 DOTS sites ≥ 1 positive smear 9 years 690 NR ND Retrospective linking of laboratory and treatment registers 579 (84)

ND, not defined; NR, not reported; PHC, primary-health-care centre.

a The period during which tuberculosis laboratory registers were reconciled with tuberculosis treatment registers is not reported. The “data collection period” is given as ranging between 2 and 8 months.

b The treatment records of all individuals with bacteriologically confirmed tuberculosis during 2007 were identified by searching electronic treatment registers for 2007 and 2008.