Pre-treatment loss to follow-up of pulmonary tuberculosis patients in two regions of Cameroon

Setting Thirty-nine tuberculosis diagnosis and treatment units (DTUs) in the North-West and South-West Regions of Cameroon. Objective To determine the proportion of pre-treatment loss to follow-up (PLTFU) of bacteriologically confirmed pulmonary tuberculosis (PTB) patients and its risk factors. Design A retrospective cohort study was conducted to retrieve information from the TB laboratory and treatment registers for all bacteriologically confirmed PTB patients diagnosed in the 39 DTUs during the last 6 months of 2015. PLTFU was defined as failure to initiate treatment within 7 days of diagnosis. Results Among 1174 bacteriologically confirmed PTB cases, the proportion of PLTFU was 16.7% (95%CI 14.7-18.9). In the multivariable logistic regression model, travelling >30 km to the DTU was a risk factor for PLTFU (adjusted odds ratio [aOR] 2.31, 95%CI 1.63-3.27) compared with travelling 30 km. Travelling for >30 min to the DTU (aOR 2.19, 95%CI 1.56-3.09) and an urban location of DTU (aOR 2.51, 95%CI 1.51-4.17) were also significant risk factors for PLTFU. Conclusion PLTFU among TB patients remains a significant issue despite the availability of free anti-tuberculosis treatment in Cameroon. Diagnosed patients should be promptly and carefully linked to a treatment unit for treatment initiation.