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Original Research



Correlates of non-compliance to follow up sputum examination and treatment outcomes among tuberculosis patients under RNTCP in tribal area of Thane district

Kalpak S Kadarkar, Daniel A Saji, Purushottam A Giri.




Abstract

Background: Revised National Tuberculosis Control Program (RNTCP) has a robust recording and reporting system in place along with multiple internal/external checks to ensure good quality data generation which forms the basis for existing supervision and monitoring strategy. However, in view of the expansion in program activities this strategy needs to be more comprehensive.

Objective: To assess response and outcome of treatment, various demographic factors associated with treatment outcome and to find out reasons for non-compliance to Directly Observed Treatment Short-course (DOTS).

Materials and Methods: A cross-sectional observational study was undertaken at designated microscopy and treatment center from May 2014 to October 2014. Tuberculosis (TB) cases registered for treatment under RNTCP in all four quarters of year 2013 were included in the study. Information collected by reviewing records with the help of predesigned and pretested schedule. Of these cases, defaulters of treatment and those cases not reported to follow up sputum examination were contacted through local health volunteers and home visits and interviewed.

Result: Of the total 126 patients, 84.9% and 15.1% were registered for Category 1 and Category 2, respectively. Pulmonary and extra-pulmonary TB accounted for 77.8% and 22.2% cases, respectively. Sputum conversion rate was 96.1%. Highest proportion of non-reporting to follow up sputum examination found in continuation phase (55.6%). Lack of awareness (23.1%) and work commitments (18.9%) were commonly given reasons for non-compliance. Treatment success rate was 85.8%. Defaulters were 3.2% and 2.4% cases were switched to multidrug-resistant TB (MDR TB) treatment.

Conclusion: Though many of performance indicators were satisfying norms of RNTCP but still significant number of cases was not reported for follow up sputum examination. Lack of awareness was the most common reason. This underlines the need of intensive IEC activity which will improve their compliance toward DOTS.

Key words: Millennium development goals (MDG), directly observed treatment short-course (DOTS), multi-drug resistant (MDR) TB, designated microscopy and treatment centre (DMC), treatment outcomes






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