CHAPTER IV - TREATMENT BEHAVIOUR OF TB PATIENTS <<Back
 
a) Treatment Failure & The Problem of Non Adherence
 
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AU : Sophia Vijay, Balasangameshwara VH & Srikantaramu N
TI : Treatment dynamics and profile of tuberculosis patients under the District Tuberculosis Programme (DTP) – A prospective cohort study
SO : INDIAN J TB 1999, 46, 239-249
DT : Per
AB :

A prospective cohort study among new smear positive pulmonary TB cases initiated on SCC was undertaken in Kolar district of Karnataka. The objective was to study the treatment outcome and patient profile of treatment adherent (completed) and non-adherent (lost) patients. Data collection was done through interviews based on pre-tested structured schedules, soon after diagnosis and at the end of treatment. Of the 224 available patients in the cohort, 120 (53.6%) completed treatment, 68 (30.4%) were lost, 29 (12.9%) died and 7 (3.1%) migrated outside the district.

Persistence of cough at the end of treatment was significantly more among lost patients. The general profile of the patients, relating to socio-economic, demographic, literacy and employment details did not differ significantly between the 2 subgroups. However, the treatment related factors like distance from health centre, knowledge of treatment duration, advice on treatment given after diagnosis, payments made to staff and for tonics were significantly more among patients lost to treatment. Raising of money to meet the expenditure, particularly through selling of valuables too was proportionately more among lost patients. Defaulter retrieval action was not taken for more than 85% of all eligibles, both among completed and lost groups. The reasons for non-adherence to treatment as emerged from the study are mainly related to the treatment organization.

The study results emphasize the need to strengthen the treatment organization to achieve the desired treatment outcome. This would also be essential for a successful implementation of DOTS strategy.

KEY WORDS: COMPLIANCE; COHORT STUDY; CASE HOLDING; INDIA.
 
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