To determine the extent and causes of Fall-out (premature abandonment of chemotherapy) and Irregularities (chemotherapy continued with interruption), 1,274 TB cases registered at the domiciliary treatment section of the Chest Department, Medical College, Calcutta, were accepted for study. Among 668 who stopped attending the clinic, 277 (21.74%) fell-out (most fell-out within the first 3 months suggesting that home visits and other efforts for patient recall should be intensified at this time). After quiescence of lesions and stoppage of chemotherapy, 21.28% (of 329 cases) fell-out during a follow-up of 1-7 years, with the trend showing an increase in fall-out with time. The Irregulars who had at least 3 months of treatment (854 cases) were defined as Major and, Minor and Regular cases. Comparative studies of these two groups with regard to several factors revealed that the Irregulars fared much worse than the Regulars except in the group with minimal (extent I) lesions. Suggestions are offered to decrease the above problems.

Impact of health education, specially, in regard to domiciliary chemotherapy, by exposing the patients to a tape-recorded message in a rural TB clinic, was evaluated. The measure appeared to have signficantly improved self- administration of the drugs as assessed by tape and post-tape regularity of chemotherapy of the patients. (From 28 pre-tapes in 1965 to 72 post-tapes in 1969). The measure also appeared to have improved knowledge in other aspects of TB as found by a comparative study of answers to questions between a group of tape-exposed tuberculous patients and another group of not exposed non-tuberculous persons on taped and untaped questions (on untaped questions, the difference was only 1.5 to 1, whereas on taped questions, this ratio was 18 to 1). It was therefore concluded, as a staff, time, and cost-saving measure, taped or gramophone recorded messages played at the clinic may prove of great educative value, specially for clinics serving predominantly illiterate patients.