Experiences of patients lost to follow up during tuberculosis treatment in Oshakati district, Namibia
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Date
2025
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University of Namibia
Abstract
Tuberculosis (TB) remains a major public health concern affecting over 10.8 million
people in 2024. Loss or lost to follow up (LTFU) during TB treatment is a pressing issue
hindering the success of TB treatment worldwide. LTFU may lead to a prolonged TB
infection, relapse, and multidrug resistance, and may contribute to treatment failure.
Despite advancements in TB treatment, many patients still experience interruptions in
their TB treatment, leading to higher rates of LTFU during TB treatment, which negatively
impact both individual health outcomes and broader public health efforts. Oshakati
District is a significant contributor to the national TB burden with a growing concern of
patients LTFU during TB treatment.
The aim of the study was to explore and describe the experiences of patients LTFU during
TB treatment in Oshakati District, Namibia. Ethical principles were applied throughout
the conduct of the study. A qualitative design was adopted using a combination of
exploratory, descriptive and phenomenological approaches. A non-probability, purposive
sampling technique was used to select 11 participants who met the inclusion criteria of the
study. A semi-structured interview was used to collect the data, and a tape recorder was
utilized. Data were thematically analyzed and the findings were presented in themes and
sub-themes.
The study identified two themes and eleven sub-themes. Findings revealed that TB
patients lost to follow-up in Oshakati District faced intertwined social, economic,
psychological, and systemic barriers. Financial hardship, stigma, weak support systems,
pill burden, side effects, and limited health literacy significantly undermined treatment
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adherence. Disengagement from care was often a reflection of survival struggles and
social exclusion rather than unwillingness. The Health Belief Model was utilized to
interpret the findings. The study concluded that the experiences of patients LTFU during
TB treatment were multifaceted.
The study recommends strengthening TB care through patient education, expanded and
accessible services, financial support, and stigma-reduction campaigns. Nurses and
Community Health Workers should provide culturally appropriate guidance, counselling,
and peer support to enhance adherence. Future research should replicate similar studies in
other districts to compare experiences of patients lost to follow-up during TB treatment.
It also acknowledges limitations related to methodological constraints, participant-related
challenges such as reluctance or bias, and difficulties in accessing certain individuals or
settings
Description
A research mini-thesis submitted in partial-fulfilment of the requirement for the degree of Master of Public Health
Keywords
Experiences, Patients, Lost to follow up, Tuberculosis, Oshakati District, Namibia, University of Namibia