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Sophia Vijay, Balasangameshwara VH & Srikantaramu
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TI |
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Treatment dynamics and profile of tuberculosis patients
under the District Tuberculosis Programme (DTP) A prospective
cohort study |
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INDIAN J TB 1999, 46, 239-249 |
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Per |
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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.
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KEY WORDS: COMPLIANCE; COHORT STUDY; CASE HOLDING;
INDIA. |