Factors Responsible for Failure to Initiate Tuberculosis Treatment among Smear Positive Tuberculosis Patients (original) (raw)
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Journal of Natural Science, Biology and Medicine, 2014
BACKGROUND: Tuberculosis affects the economically productive age group and has emerged as a significant cause of socio economic global burden. OBJECTIVE: To find out epidemiological factors responsible for Tuberculosis and the clinico-social correlates influencing their compliance. METHODS: This study was carried out among all the New Smear Positive Tuberculosis (NSP-TB) patients registered in Dhubri District Tuberculosis Centre (DTC-TU) during 2007 in Assam by interview technique using a pre-tested questionnaire. RESULTS: Overall 90.76 percent of the participants were in the age group of 15 to 55 years. Majority of them were unskilled workers and were the sole earning member of their family. 83.33% of the patients had symptoms of cough for more than three weeks. Almost all of the patient's houses (98.15%) were found to be overcrowded. More than half of the patients had X-ray examination as their initial approach to diagnosis. There were more males (59.18%) than females (40.82%) who had reported to the health institution within first 6 weeks after the onset of symptom & among them altogether 91.84 % were declared cured after completion of therapy. On the contrary, only 40% of the patients initiating treatment after 6 weeks of the onset of symptoms were declared cured after completion of therapy. Long distance to the treatment centre, unpleasant effect of the drug and personal inconvenience were cited as cause of irregular treatment and defaulting. CONCLUSIONS: The prevalence of NSP TB cases was more among the illiterate and underprivileged population who needs counseling & motivation for early intervention.
BACKGROUND: Tuberculosis affects the economically productive age group and has emerged as a significant cause of socio economic global burden. OBJECTIVE: To find out epidemiological factors responsible for Tuberculosis and the clinico-social correlates influencing their compliance. METHODS: This study was carried out among all the New Smear Positive Tuberculosis (NSP-TB) patients registered in Dhubri District Tuberculosis Centre (DTC-TU) during 2007 in Assam by interview technique using a pre-tested questionnaire. RESULTS: Overall 90.76 percent of the participants were in the age group of 15 to 55 years. Majority of them were unskilled workers and were the sole earning member of their family. 83.33% of the patients had symptoms of cough for more than three weeks. Almost all of the patient's houses (98.15%) were found to be overcrowded. More than half of the patients had X-ray examination as their initial approach to diagnosis. There were more males (59.18%) than females (40.82%) who had reported to the health institution within first 6 weeks after the onset of symptom & among them altogether 91.84 % were declared cured after completion of therapy. On the contrary, only 40% of the patients initiating treatment after 6 weeks of the onset of symptoms were declared cured after completion of therapy. Long distance to the treatment centre, unpleasant effect of the drug and personal inconvenience were cited as cause of irregular treatment and defaulting. CONCLUSIONS: The prevalence of NSP TB cases was more among the illiterate and underprivileged population who needs counseling & motivation for early intervention.
Background: Treatment nonadherence is major challenge before tuberculosis (TB) control activities. Treatment adherence is the result of interactions of various factors related to the patient, provider, health setup, type of illness, and sociocultural factors. Aim: The aim was to assess baseline knowledge of new smear-positive TB patients about their disease and treatment and to find its impact on treatment adherence. Methods: New sputum-positive TB patients initiated directly observed treatment short-course in ward E of Mumbai district in first two-quarters of the calendar year were enrolled in the study. They were interviewed by trained interviewer as per pretested semi-structured interview schedules to collect sociodemographic information and to assess their knowledge after verbal consent. Treatment adherence was noted by screening treatment cards after any final outcome of the treatment as per Revised National Tuberculosis Control Program. Data were entered in Microsoft excel and analyzed using SPSS 15.0 software (developed by IBM, Chicago, USA in 2007). Results: Out of 157 patients enrolled, 150 could be interviewed. The majority were in reproductive age group and from class IV and V socioeconomic class. Good knowledge about infectiousness, reasons behind TB, its spread, curability, and treatment duration was found in 29.5%, 28.8%, 16%, 59%, and 22.3%, respectively. 72/150 were treatment adherent and good knowledge about all these aspects was significantly associated with treatment adherence. Most significant association was found with good knowledge about infectiousness of TB (odds ratio: 1.764, P < 0.001). Conclusions: Thorough knowledge regarding TB and its treatment should be given to the TB patients at the initiation of the treatment may help to improve treatment adherence.
Background: Adhering to treatment is the lion's share rests with the patients. There are others who share an equal responsibility so that the patients can adhere to the treatment regimen and also enhance compliance ie. health care workers, public health officials, governments and communities, all share the responsibility and provide a range of support services that are needed to continue and finish the treatment. Objectives: To study factors influencing treatment outcome of New Sputum Smear Positive Tuberculosis patients in Tuberculosis Unit (TU) Khammam. Materials & Methods: The present study is a prospective study of patients registered under RNTCP in Khammam TU. All the new sputum smear positive patients registered in Khammam TU during the second and third quarters of 2009 were enrolled as study subjects. A total of 413 patients were registered.Results: Of the enrolled patients cure rate was 85.47%, default rate was 4.84%, failure rate was 4.84%, treatment completed rate was 0.48% and death rate was 4.36%. Conclusion: Socio demographic, Initial sputum grading, comorbidities, habits influence the treatment outcome of tuberculosis patients who are on Directly Observed Treatment Short course chemotherapy.
Knowledge and health seeking behaviour of tuberculosis patients in Kerala, India
International Journal of Community Medicine and Public Health, 2016
Tuberculosis (TB), the ancient scourge of man, continues to be a major global public health problem in the twentyfirst century. According to World Health Organization (WHO), one-third of the world's population is estimated to have Mycobacterium tuberculosis. The Revised National Tuberculosis Control Programme (RNTCP), based on the internationally recommended Directly Observed Treatment Short-course (DOTS) strategy, launched in 1997 has expanded across the country in a phased manner. Full nationwide coverage was achieved in March 2006. In spite of its impressive performance in terms of case detection and cure rates, the programme has many challenges due to the different health seeking pattern. Patients with undiagnosed pulmonary TB predominantly ABSTRACT Background: Patients confront several problems in timely and effective utilization of TB health facilities which have often delayed diagnosis of TB. It is hence the need of the hour to look beyond the case detection rates towards other factors that can promote early diagnosis. Methods: A community-based cross-sectional study was conducted among newly diagnosed smear positive pulmonary tuberculosis patients aged ≥15 years on the Intensive Phase of treatment. A pretested semi-structured questionnaire was used to study knowledge, stigma, health seeking behaviour and other factors. Results: The predominant symptom for seeking care was cough (93.0%). 45.7% of patients sought the services of a health care provider within 2 weeks. Modern medicine was the preferred system for 94.7% of the patients. The majority (58.6%) of the patients consulted a private health facility. Illiterates and Below Poverty Line patients preferred government facilities. The average number of consultations before diagnosis was 3.11±1.9. 34.1% had adequate knowledge about tuberculosis and women had a significantly higher knowledge score. low per capita income, smoking and alcohol use, cough alone, cough with other symptoms, history of TB in Family, distance more than ≥ 5 km to health facility showed significant association with delayed health-seeking action (>14 days). Conclusions: Private practitioners and private hospitals were the predominant health providers preferred by the study subjects for the first consultation. Delayed health seeking action was probably due to the presence of a cough alone and coughs with other symptoms, history of tuberculosis among the family members and increased distance to TB health facility.
Journal of Microbiology and Infectious Diseases
Introduction: Tuberculosis (TB) treatment failure is one of the major problems of the health sector in developing countries. Poor treatment of patients leads to drug resistance, relapse, death, and ultimately prevents TB control programs. This study was conducted to determine the factors affecting tuberculosis treatment failure in Khorasan and Sistan-Balochistan regions which have a high prevalence of TB. Methods: In this case-control study 270 patients with tuberculosis (90 cases, 180 controls) were analyzed. New TB patients registered with failure to treatment according to the national protocol between March 2008-March 2012 were chosen as cases and new TB patients with negative sputum smear in the same time frame were enrolled as control group. Demographic data and clinical treatment outcomes were collected through interviews and file records. Multivariate logistic regression analysis was used to determine the predictors of treatment failure in SPSS 19. Results: Independent factors and predictors of failure treatment included illiteracy, a three plus positive sputum smear, positive sputum smear at end of the second month, non-implementation of the Directly Observed Treatment Short strategy by healthcare staff, history of addiction and history of diabetes. Conclusion: Intervention programs for early detection and control of diabetes, drug control programs, giving priority to providing DOTS by health care workers, more individual care and attention to patients with initial smear p + 3 or those that remain sputum positive at the end of the second month or those who are less educated is necessary.
South East Asia Journal of Public Health, 2015
Under the Revised National Tuberculosis Control Programme (RNTCP), Tuberculosis services are provided free of charge in India; all diagnosed TB patients are initiated on treatment within 7 days. Initial default is a potentially serious problem, particularly in cases of smear positive patients because they may continue transmitting the disease. This study was conducted to estimate the proportion of new sputum positive pulmonary TB patients who dropped out before initiating treatment, and their reasons for not registering for treatment. A cross-sectional study was carried out at Darjeeling District from July 2011 to April 2012 among 132 initial defaulters. Initial defaulter rate was 23.5%. A majority of the defaulters were 15-29 years old (59.10%); male (70.45%); from rural areas (80.06%); literate (78.79%); employed (86.36%); married (71.97%); non-smokers (77.27%); and had a mean per capita monthly income of Rs 741.40. Age, literacy, employment, marital status, smoking habits, alcoho...
Journal of infection in developing countries, 2012
The Revised National Tuberculosis Control Program (RNTCP) aims to achieve detection of 70% of new smear-positive patients in a community and to cure 85% of such patients. Though an elaborate recording and reporting system is in place to monitor the success of the program, no record of patients who do not complete the diagnostic process is currently maintained. The present study, performed in a tertiary care hospital, attempted to estimate the proportion of this group of patients, who were labeled "diagnostic defaulters. This prospective observational study was conducted over one year on consecutive patients presenting with cough of more than two weeks' duration. A total of two sputum samples were obtained from each patient, including a spot sample and a morning sample collected on the following day. Zeihl-Neelsen staining, reporting and external quality assessment of smear-microscopy was done per RNTCP guidelines. Of the 2,349 patients recruited, 175 defaulted on the second...