Publication:

Study of various causes of defaulter among tuberculosis patients under revised national tuberculosis control programme: a prospective analysis of 5235 tuberculosis patients

Background The world health organization (WHO) declared tuberculosis (TB) a global public health emergency in 1993 and since then intensified its efforts to control the disease worldwide. Poor compliance with tuberculosis (TB) treatment has reportedly been cited as one of the major obstacles which have led to spread of TB and development of multi-drug resistant and extensively drug resistant tuberculosis. The objective is to investigate factors contributing to treatment non-adherence among patients on TB treatment, the results of which might help us to design intervention that would promote compliance.

Methods All TB patients admitted to the Institute were interviewed regarding the past history of anti-tuberculosis treatment (AKT). As per the revised national tuberculosis control programme (RNTCP) guidelines, we defined defaulter as patient who had interrupted AKT for more than 2 months. All the interviewed patients had taken AKT at RNTCP DOT sites. Patient who has taken AKT from private institute were excluded. All the defaulted patients were then interviewed in details. In addition to the personal and socio-demographic data, treatment history was recorded in details along with reasons for stopping treatment.

Results Among 5235 TB patients, 405 (7.7%) were found to have a past history of AKT interruption. The highest number of treatment interrupters were in the age group 21 to 50 years (n=309), constituting nearly 76.29% of all the patients studied. The most common reason stated was AKT-induced side effects (42.2%) a feeling of early improvement (33.3%) and followed by migration for work (9.6%).

Conclusions Present study concludes that the most common cause of defaulters amongst tuberculosis patients are adverse effects, feeling of early improvement and migration.