India has the world's highest tuberculosis (TB) burden in terms of absolute numbers of incident cases every year. RNTCP services are delivered in integration with general health services, primarily by public health institutions, and a robust routine surveillance system for reporting of TB cases registered for treatment is in place. Although TB was declared a notifiable disease in 2012, most private practitioners still fail to report TB cases to the RNTCP. The profile of TB cases diagnosed in the private sector in terms of new ( defined as patients never treated for TB or those who have received treatment for, 1 month) or previously treated (defined as patients who have received treatment for TB for > 1. month from any source ), disease classification as smear-positive pulmonary TB (PTB), smear-negative PTB, extra-pulmonary TB (EPTB) and age-sex distribution, is thus largely unknown. The article presents findings of a descriptive study carried out by National Tuberculosis Institute, Bangalore with an objective to ascertain the profile of TB patients diagnosed and / or treated in private health care facilities in a South Indian district and the proportion registered under routine RNTCP surveillance data.

The study was carried out in Tumkur District, in Karnataka State. Private health care facilities in the district included a medical college, 83 nursing homes with in-patient facilities, a large number of clinics, each managed by a single practitioner, private diagnostic laboratories. Data on TB cases diagnosed and / or treated in all clinical departments of the medical college, 83 nursing homes and RNTCP health care facilities were collected prospectively.

About 83% of new TB cases recorded in the private medical college, 47% in nursing homes and 24.5% in RNTCP TB registers were extra-pulmonary. The proportion of retreatment cases was respectively 5.5%, 9.6% and 19.8%. The proportion of males and those in the economically productive age group were similar in the three data sources. About 94% of cases diagnosed in the medical college and 55% in nursing homes were registered for treatment under the RNTCP. About 11% of the smear-positive patients diagnosed in RNTCP were initial defaulters. The proportion of extra- pulmonary cases was higher in the medical college and nursing homes and that of retreatment cases was lower than in the RNTCP.