Pre-Treatment Loss to Follow Up of Tuberculosis Patients; Prevalence and Reasons for It in Central Karnataka, India


  • Satish Ghatage JJM Medical College, Davangere, India
  • Shubha D B JJM Medical College, Davangere, India
  • Latha S Shri B M Patil Medical College, hospital and research centre, Vijayapura, India
  • Shameem R Kanganolli Shimoga Institute of Medical Sciences, Shimoga, India



Tuberculosis , Pre-treatment, Prevalence, Diagnosis


Background: Pre-treatment loss to follow up (PTLFU) is defined as diagnosed TB patients not initiated on treatment within 14 days of TB diagnosis. Bringing these PTLFU cases into care can reduce the disease transmission and mortality. The present study was undertaken with main objectives to study the prevalence of PTLFU in TB patients and to know the reasons for PTLFU.

Methodology: A cross-sectional study was conducted among 38 PTLFU TB patients of Davangere district, Karnataka from January to March 2019. Study participants were personally interviewed using pre-tested, semi-structured questionnaire. Data was analyzed using SPSS software.

Results: The prevalence of PTLFU in TB patients is 3.6%. The reasons for PTLFU were, out of the 38 study subjects, 17 (47%) of them were initiated on treatment in private sector but reported as PTLFU. 7 (18%) died in hospital before treatment initiation. 7 (18%) did not start the treatment because of fear of side effects following anti tuberculosis treatment, whereas 2 (6%) of them did not take treatment by seeing the side effects in others and 5 (13%) had alcoholic withdrawal effects.

Conclusions: Improvement in recording of contact details, biometric registration of all presumptive TB cases and pre-treatment counselling of all diagnosed TB patients may reduce PTLFU.


Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine. 20th ed. New York: McGraw-Hill Education/Medical; 2018.

END TB Strategy.Geneva Switzerland:World Health Organisation; 2015. 20p.WHO/HTM/TB/2015.19

National strategic plan for tuberculosis elimination 2017-2025. [Online]. 2016 [cited 2021 Oct 19];[109]. Available from: URL:

Dye C, Bassili A, Bierrenbach AL, Broekmans JF, Chadha VK, Glaziou P, et al. Measuring tuberculosis burden, trends, and the impact of control programmes. Lancet Infect Dis. 2008;8:233-43. Doi:

The Stop TB Strategy Geneva: World Health Organization. Stop TB Partnership; 2006.

Harries AD, Rusen ID, Chiang CY, Hinderaker SG, Enarson DA. Registering initial defaulters and reporting on their treatment out-comes. Int J Tuberc Lung Dis. 2009;13:801-3.

Zachariah R, Harries AD, Srinath S, Ram S, Viney K, Singogo E, et al. Language in tuberculosis services: can we change to patient-centred terminology and stop the paradigm of blaming the patients? Int J Tuberc Lung Dis. 2012;16:714-7. Doi: PMid:22613683

Squire SB, Belaye AK, Kashoti A, Salaniponi FM, Mundy CJ, Theobald S, et al. 'Lost' smear-positive pulmonary tuberculosis cases: where are they and why did we lose them? Int J Tuberc Lung Dis. 2005;9(1):25-31.

Dowdy DW, Chaisson RE. The persistence of tuberculosis in the age of DOTS: reassessing the effect of case detection. Bull World Health Organ. 2009;87:296-304. Doi: PMid:19551238 PMCid:PMC2672581

Peter MacPherson,a Rein MGJ Houben,b Judith R Glynn,b Elizabeth L Corbettc & Katharina Kranzer. 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 Bull World Health Organ 2014;92:126-138. Doi: PMid:24623906 PMCid:PMC3949536

Thomas BE, Subbaraman R, Sellappan S, Suresh C, Lavanya J, Lincy S, Raja AL, Javeed B, Kokila S, Arumugam S, Swaminathan S. Pre-treatment loss to follow-up of tuberculosis patients in Chennai, India: a cohort study with implications for health systems strengthening. BMC infectious diseases. 2018 Dec;18(1):1-1. Doi: PMid:29587651 PMCid:PMC5872574

Tiemersma EW, van der Werf MJ, Borgdorff MW, Williams BG, Nagelkerke NJ. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS One. 2011;6(4):e17601. Doi: PMid:21483732 PMCid:PMC3070694

Korenromp EL, Bierrenbach AL, Williams BG, Dye C. The measurement and estimation of tuberculosis mortality. Int J Tuberc Lung Dis. 2009;13:283-303.

Kurd SA, Wali A, Fatima R, Yaqoob A, Khan D, Lehri S. Pre-treatment loss to follow-up among patients with rifampicin-resistant tu-berculosis in Baluchistan, Pakistan, 2012-17: a retrospective cohort study. F1000Research. 2018 Dec 7;7(1905):1905. Doi:

Pillai D, Purty AJ, Prabakaran S, Singh Z, Soundappan G, Anandan V. Initial default among tuberculosis patients diagnosed in selected medical colleges of Puducherry: issues and possible interventions. Int J Med Sci Public Health. 2015 Jul 1;4(7):957-60. Doi:

Jayabal L, Frederick A, Mehendale S, Banurekha V. Indicators to ensure treatment initiation of all diagnosed sputum positive pulmo-nary tuberculosis patients under tuberculosis control programme in India. Indian journal of community medicine: official publica-tion of Indian Association of Preventive & Social Medicine. 2017 Oct;42(4):238. Doi: PMid:29184327 PMCid:PMC5682726

Pithadia PR, Dhaduk KM, Chauhan MM, Parmar DV, Ghanchi FD, Dholakiya BB. A study on prevalence of initial defaulters among spu-tum smear positive TB patients and their reasons under RNTCP in Jamnagar district, Gujarat, India. Healthline, Journal of Indian As-sociation of Preventive and Social Medicine. 2017;8(2):36-41.

Ramachandran R, Nalini S, Chandrasekar V, Dave PV, Sanghvi AS, Wares F, et al. Surveillance of drug-resistant tuberculosis in the state of Gujarat, India. Int J Tuberc Lung Dis. 2009;13(9):1154-1160.

Chadha VK. Tuberculosis epidemiology in India: a review. Int J Tuberc Lung Dis. 2005;9(10):1072-1082.

B. SaiBabu, A. V. V. Satyanarayana, G. Venkateshwaralu, U. Ramakrishna, P. Vikram,S. Sahu,et al. Initial default among diagnosed spu-tum smear-positive pulmonary tuberculosis patients in Andhra Pradesh, India Int J Tuberc Lung D. 2018; 12(9):1055-8.




How to Cite

Ghatage S, D B S, S L, Kanganolli SR. Pre-Treatment Loss to Follow Up of Tuberculosis Patients; Prevalence and Reasons for It in Central Karnataka, India. Natl J Community Med [Internet]. 2022 Oct. 31 [cited 2022 Dec. 9];13(10):724-7. Available from:



Original Research Articles