risk factors associated with lost to follow up among multidrug resistance tuberculosis patients registered for treatment in programmatic management of drug resistant tuberculosis sites of punjab, pakistan

Introduction: pakistan, a country with a 27 high burden countries of multidrug resistance tuberculosis. to predict the associated risk factors and proportion of loss to follow up among mdr-tb patients treated at pmdt sites of punjab from 2017 to 2019. methodology: this case control study based on the standardized reporting and recording case record forms called as electronic nominal review system (enrs) of national tb control program, pakistan. a logistic regression model was used to assess risk factors of lost to follow up mdr-tb patients. results: a total of 539 patients with mdr-tb were included in the final analysis. among them, 207 patients (7.5%) had lost to follow up outcome at the end of the study. mdr-tb lost to follow up patients were more likely to report older age (aor: 1.40, ci: 1.14-1.71, p=0.000), history of lost to follow up from first line drugs treatment (aor: 0.39, ci: 0.28-0.56, p=0.000), co-morbid (aor:1.54, ci: 1.24-1.91, p=0.000), adverse reaction of second line drugs (aor: 0.45, ci: 0.37-0.56, p=0.000), long distance between patient’s home and pmdt site (aor: 0.68, ci: 0.52-0.89, p=0.001). conclusion: the history of lost to follow up from first line drugs treatment, co-morbid, older age and long distance were independent risk factors of mdr-tb. proper training for pmdt sites staff, friendly follow up services and psychological counseling may help to reduce lost to follow up.