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Study of treatment interruption of new sputum smear positive TB cases under DOTS strategy

Sultan R Ahmad, Gajanan D Velhal.




Abstract

Background: In 1993 GoI launched RNTCP and adopted DOTS-Strategy, to revitalize the TB control programme in India.

Aims & Objective: This study attempts to find out the prevalence and reasons for non-adherence /non-compliance to DOTS.

Materials and Methods: Community based prospective observational study was conducted with 281 newly diagnosed sputum positive TB cases. The follow-up sputum examination, interruption from treatment and reasons for non-adherence details were obtained at the end of the 2nd, 4th & 6th month for sputum smear negative TB cases and 5th & 7th month for sputum smear positive TB cases.

Results: Study shows 25% of the cases did not report for follow up sputum smear examination after intensive phase and 50% of the cases at the end of follow up. Main reasons for not attending the follow-up sputum smear examination were lack of awareness (45%) and workload (31%). During the treatment period, 28 % were interrupted in intensive phase and 40% interrupted in continuation phase and 29% were defaulters. The reasons for treatment interruption were adverse effects (39%), lack of personal interest (27%) and work load (27%). Treatment interruption was more in age group of 0-50 years (74.87%), male (74.54%), illiterate (77.38%) and labourers (75.32%).

Conclusion: Noncompliance was found to be mainly due to lack of unawareness, lack of time, side effects of medicines, which can be modified by IEC and focus service delivery on high risk groups.

Key words: Revised National TB Control Programme (RNTCP); Directly Observed Treatment, Short-Course (DOTS); Cured; Treatment Completion; Defaulter






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