Pretreatment Lost to Follow-up Tuberculosis Patients, Lusaka, Zambia, 2024: A Retrospective Cohort Study

The proportion of PT-LTFU was 12.5% in the four facilities in Lusaka, Zambia, in 2024. This was slightly higher than in a previous study conducted in Lusaka in 2020. The proportions of PT-LTFU were significantly higher among those diagnosed as lower positives with Xpert MTB/RIF, probably because the patients may not have been convinced they had TB. There is a need to strengthen the capacity of laboratories to provide same-day results for patients to reduce the rate of PT-LTFU. Furthermore, there should be strengthened departmental linkages and improved documentation of patients' contact details at health facilities to facilitate patient follow-up for TB service provision and tracing. Enhanced laboratory turnaround, real-time linkage of diagnostic and treatment registers, and improved patient tracing are essential to reduce PT-LTFU and align with the World Health Organization End-TB targets.