Presumptive pulmonary tuberculosis cases loss to follow up before diagnosis and its associated factors in tertiary care institute

A BSTRACT Background: This study aimed to estimate the proportion of presumptive pulmonary tuberculosis (PTB) cases lost to follow-up (LTFU) before diagnosis at a tertiary care facility and explore associated factors. Methods: A mixed-method study (sequential explanatory, QUAN-qual) was conducted at the pulmonary Outpatient Department of a tertiary care institute from November 2022 to June 2023. Quantitative data were collected using a semi-structured questionnaire and analyzed with IBM SPSS trial version 25. Qualitative data were obtained through in-depth interviews using the Health Care Access Barriers model. Results: Out of 160 cases, 63.7% were males, and 84.4% underwent sputum testing. The qualitative findings highlighted structural, financial, and cognitive constraints causing diagnostic delays. A total of 15.6% of pulmonary Tuberculosis (TB) cases were LTFU before diagnosis. Conclusion: This study revealed significant pretreatment LTFU in pulmonary TB cases, influenced by factors such as healthcare access, socioeconomic status, literacy, and societal norms.