The paper presents some aspects of domiciliary management of tuberculosis patients in a District Tuberculosis Programme (DTP) viz., the interval between diagnosis and initiation of treatment, regularity in collection of drugs, role of motivation of patients for collection of drugs and pattern of defaulter retrieval actions by health institutions. The treatment cards of 3089 patients of pulmonary tuberculosis belonging to Bangalore DTP diagnosed during 1964 were analysed. The cohort of 2479 patients was divided into 3 groups according to the place of treatment, viz., (i) those treated at District Tuberculosis Centre (DTC) where better trained staff motivated tuberculosis patients & took defaulter actions (ii) the Urban Peripheral Health Institutions (UPHIs) where motivation and defaulter actions were taken by specialised staff and (iii) rural PHIs where non- specialised general health workers along with general duties did motivation and took defaulter actions.

The study has shown that in the entire district about 94% of patients were put on treatment within 10 days of diagnosis. In rural PHIs, among 14.5% of patients the treatment was started after 10 days of diagnosis. For the 149 initial defaulter patients, actions were taken only for 39% of the patients, lowest being in rural PHIs (10.8%). The defaulter actions for 69% were taken in time, more promptly by DTC staff for DTC & UPHI i.e. 71.5%, whereas rural PHIs were poor in this respect and only 37.5% of the actions were taken on time. Sputum positive cases collected drugs more often than sputum negative and also more patients collected drugs on due dates at DTC in comparison with PHIs. Both the differences were statistically significant.

About one third of the lost patients came from those who made the first default. About 55-63% and 75-82% of this group defaulted by the second and third collections respectively. Defaulter actions were not taken by rural PHIs for 66.7 to 72.5% defaults, while DTC staff had not taken defaulter action for about 20% of defaulters and 67.8% of such actions were prompt in DTC, whereas it was only 19.3% in rural PHIs.