Lost to Follow-Up Defined at Kisoro District Hospital, Uganda, by Hospital Unit

Hospital UnitLTFU DefinitionRationaleFrequency of Chart Review
Ward dischargeMissed first CCC appointment by 1 monthApproximate time before clinical deterioration and/or depletion of medications.Weekly
Inpatient TB registryMissed drug refill appointment by 2 or more weeksPatients pick up medication every 2 weeks; public health implications for breaks in treatment are significant.Monthlya
HIV clinicMissed 2 monthly appointments (either pre- or post-ART initiation)Although patients are scheduled to pick up medications monthly, many come 1 or 2 weeks post-appointment, so a 2-month interval captures the late-comers.Every 2 weeks
Chronic Care ClinicPatient with at least 2 prior visits (i.e., regular CCC patient) who has not returned for 3–6 months, depending on disease severity (3 months for most severe 25% of patients, 6 months for less severe)Risk severity stratification applied due to large number of CCC patients and limited outreach capacity.Every 2 months
Nutrition clinicMissed 1 appointmentLow threshold applied due to population of vulnerable children.Monthly
  • Abbreviations: ART, antiretroviral therapy; CCC, Chronic Care Clinic; LTFU, lost to follow-up; TB, tuberculosis.

  • a TB patients identified as LTFU could be off their medications for more than 1 month since staff identify TB patients LTFU once a month.