Characteristics of and risk factor for prediagnostic loss to follow-up (PDLFU) among presumptive TB cases referred for diagnostic evaluation between January 2018 and December 2018 in Samastipur, India
| Characteristics | Presumptive TB cases, n | Not evaluated, n (%) | Unadjusted RR (95% CI) | P value | Adjusted RR* (95% CI) | P value | |||
| Total | 11 146 | 6234 | (55.9) | ||||||
| Block | |||||||||
| Ujiarpur | 3620 | 2060 | (56.9) | 1.0 | (1.0 to 1.1) | 0.022 | – | ||
| Bibhutipur | 3673 | 2083 | (56.7) | 1.0 | (1.0 to 1.1) | 0.033 | – | ||
| Sarairanjan | 3853 | 2091 | (54.3) | Ref | – | ||||
| Age (years) | |||||||||
| <15 | 2385 | 1625 | (68.1) | 1.4 | (1.3 to 1.4) | <0.001 | 1.2 | (1.2 to 1.3) | <0.001 |
| 15–44 | 4661 | 2459 | (52.8) | 1.0 | (1.0 to 1.1) | 0.139 | 1.0 | (1.0 to 1.1) | 0.366 |
| 45–64 | 2789 | 1464 | (52.5) | 1.0 | (1.0 to 1.1) | 0.212 | 1.0 | (1.0 to 1.1) | 0.164 |
| ≥65 | 1169 | 588 | (50.3) | Ref | Ref | ||||
| Gender | |||||||||
| Female | 5827 | 3375 | (57.9) | Ref | Ref | ||||
| Male | 5319 | 2859 | (53.8) | 1.1 | (1.0 to 1.1) | <0.001 | 1.1 | (1.0 to 1.1) | 0.001 |
| Source of referral | |||||||||
| ASHA | 8428 | 4690 | (55.7) | 1.3 | (1.2 to 1.4) | <0.001 | 1.2 | (1.1 to 1.3) | <0.001 |
| AWW | 88 | 52 | (59.1) | 1.3 | (1.1 to 1.6) | 0.003 | 1.2 | (1.0 to 1.5) | 0.025 |
| RMP | 617 | 271 | (43.9) | Ref | Ref | ||||
| Community | 2013 | 1221 | (60.7) | 1.4 | (1.3 to 1.5) | <0.001 | 1.3 | (1.2 to 1.4) | <0.001 |
| Previous history of anti-TB treatment | |||||||||
| Yes | 2501 | 1034 | (41.3) | 0.7 | (0.6 to 0.7) | <0.001 | 0.7 | (0.7 to 0.8) | <0.001 |
| No | 8645 | 5200 | (60.2) | Ref | |||||
| Presence of signs and symptoms† | |||||||||
| Haemoptysis in last 6 months | 1346 | 494 | (36.7) | 0.6 | (0.6 to 0.7) | <0.001 | 0.7 | (0.6 to 0.7) | <0.001 |
| Cough ≥2 weeks | 8895 | 4514 | (50.8) | 0.7 | (0.6 to 0.7) | <0.001 | – | ||
| Sputum | 6184 | 2779 | (44.9) | 0.6 | (0.6 to 0.7) | <0.001 | – | ||
| Chest pain in last 1 month | 7061 | 3260 | (46.2) | 0.6 | (0.6 to 0.7) | <0.001 | – | ||
| Fever ≥2 weeks | 8242 | 4289 | (52.0) | 0.8 | (0.8 to 0.8) | <0.001 | – | ||
| Night sweats ≥2 weeks | 3730 | 1724 | (46.2) | 0.8 | (0.7 to 0.8) | <0.001 | – | ||
| Severe weight loss in last 3 months | 8318 | 4254 | (51.1) | 0.7 | (0.7 to 0.8) | <0.001 | – | ||
| Swelling in a lymph node | 2067 | 1517 | (73.4) | 1.4 | (1.4 to 1.5) | <0.001 | – | ||
| Other factors† | |||||||||
| Alcohol user | 159 | 90 | (56.6) | 1.0 | (0.9 to 1.2) | 0.862 | – | ||
| Tobacco user | 2280 | 1109 | (48.6) | 0.8 | (0.8 to 0.9) | <0.001 | – | ||
Age is missing for 142 presumptive cases and 98 not evaluated cases.
All % are row percentages.
P value ≤0.05 is considered significant.
*While building the model for multivariate Poisson’s regression analysis, all the signs and symptoms except haemoptysis were dropped because of high collinearity assessed on the basis of high variance inflation factor. The final variables in the model were selected on the basis of likelihood ratio testing.
†For signs, symptoms and other factors, the absence of that characteristic sign and symptoms was considered as the reference category.
ASHA, accredited social health activist; AWW, Anganwadi worker; RMP, registered medical practitioner; RR, relative risk; TB, tuberculosis.