IJCRR - Vol 07 Issue 08, April, 2015
AN EPIDEMIOLOGICAL STUDY OF DETERMINANTS OF DEFAULTER UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAM IN OLD CITY OF HYDERABAD
Author: Pisudde P. M., Sushma Katkuri, Nithesh Kumar, Taywade M. L.
Introduction: In India TB report 2014 it was stated that, out of the estimated global annual incidence of 8.6 million TB cases, 2.3 million were estimated to have occurred in India till 2012. As per WHO, Tuberculosis prevalence per lakh population has reduced from 465 in year 1990 to 230 in 2012. Defaulting from treatment has been one of the major obstacles to treatment management and an important challenge for TB control. To ensure treatment adherence, Directly Observed Treatment - Short Course (DOTS) is a main strategy. It becomes imperative to understand the determinants of default under DOTS so that necessary actions can be taken up to prevent defaults under the program. Hence, the present study was undertaken to study the determinants of default under DOTS.
Material and methods: Case control study was carried out in “Bhavani Nagar” urban slum area of Hyderabad in old city and study subject were selected. Study duration was from 1st January 2011 to 31 December 2012 and data was collected from June 2013 to July 2013 by interviewing study subjects. The data collected was entered and analyzed using epi_info 6.04d. The study has been conducted after being approval from Institutional Ethical Committee.
Results and conclusion: The odds of getting default were 2.4 times more when the study subjects belongs to OBC caste but was not found statistically significant. The risk of getting defaulter was 3.2 times more in study subjects studied less than higher secondary when compared with study subjects studied more than equal to higher secondary but was not found statistically significant. Major reason for defaulting was disappreance of the symptoms i.e. 33.3%, followed by intolerance of drugs(26.1%). It was found that having nuclear family is one of the determinant for defaulting. It was also seen that old cases of TB were associated with defaulting this may be due to the drugs intolerance or due to the disappearance of symptoms or their adherence
to treatment requires more counseling. Defaulting was also found significantly associated with DOTS provider who were from
the health department.
Keywords: Case control study, Tuberculosis, Defaulters
Pisudde P. M., Sushma Katkuri, Nithesh Kumar, Taywade M. L.. AN EPIDEMIOLOGICAL STUDY OF DETERMINANTS OF DEFAULTER UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAM IN OLD CITY OF HYDERABAD International Journal of Current Research and Review. Vol 07 Issue 08, April, 56-62
1. Central TB division, DGHS, Ministry of Health and Family welfare. TB India 2014, RNTCP Status Report. New Delhi; 2014.
2. Snider DE Jr. An overview of compliance in tuberculosis treatment programmes; Bull Int Union Tuberc 1982; 57: 247-52.
3. Brudney K, Dobkin J. Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs; Am Rev Respir Dis 1991; 144: 745-79.
4. Davidson BL. A control comparison of directly observed therapy vs self-administered therapy for active tuberculosis in the urban United States. Chest 1998; 114: 1239-43.
5. Weis SE, Slocum PC, Blais FX, King B, Nunn M, Matney GB et al; The effect of directly observed therapy on the rates of drug resistance and relapse in tuberculosis; N Engl J Med. 1994; 330: 1179-84.
6. Khatri, G.R., Frieden, T.R.; The status and prospects of tuberculosis control in India; Int J Tuberc Lung Dis 2000; 4(3): 193-200.
7. Sophia Vijay, VH Balasangameswara, PS Jagannatha, VN Saroja, P Kumar. Defaults among tuberculosis patients treated under DOTS in Bangalore city : a search for solution. Ind. J Tub., 2003, 50,185
8. Frieden TR, Fujiwara PI, Washko RM, Hamburg MA. Tuberculosis in New York City-turning the tide. N Engl J Med. 1995 Jul 27;333(4):229-233.
9. Chandrasekaran V, Gopi P, Subramani R, Thomas A, Jaggarajamma K, Narayanan P. Default during the intensive phase of treatment under DOTS programme. Indian J Tuberc 2005;52:197-202.
10. Chatterjee P, Banerjee B, Dutt D, Pati RR, Mullick AK. A complete evaluation of factors and reasons for defaulting in tuberculosis treatment in the state of West Bengal, Jharkhand and Arunachal Pradesh. Indian J Tuberc, 2003,50:17-22.
11. Yeung MC, Noertjojo K, Leung CC, Chan SL, Tam CM. Prevalence and predictors of default from tuberculosis treatment in Hong Kong Hong Kong Med J 2003;9:263-68.
12. Comolet TM, Rakotomalala R, Rajaonarioa. Factors determining compliance with tuberculosis treatment in an urban environment, Tamatave, Madagascar Int J Tuberc Lung Dis 1998; 2(11):891–897.
13. Daniel OJ, Alausa OK. Default from tuberculosis treatment programin Samagu, Nigeria. Nigerian J Medicine2006; 15(1): 63-70.
14. Jaggarajamma K, Muniandy M, Chandrasekaran V, Thomas SG, Gopi PG, Santha T. Is migration a factor leading to default under RNTCP. Indian J Tuberc 2006;53:33-36.
15. Jaggarajamma K, Sudha G, Chandrasekaran V, Nirupa C, Thomas A, Santha T et al. Reasons for non-compliance among patients treated under revised national tuberculosis control programme(RNTCP), Tiruvallur district, South India. Indian J Tuberc 2007; 54:130-135.
16. Santha T, Garg R, Frieden TR, Chandrasekaran V, Subramani R, Gopi PG et al. Risk factors associated with default, failure and death among tuberculosis patient treated in a DOTS programme in Tiruvallur district, South India, 2000. Int J Tuberc Lung Dis. 2003 Feb;7(2):200-1.
17. Balasubramanian R, Garg R, Santha T, Gopi P, Subramani R, Chandrasekaran Vet al. Gender disparities in tuberculosis: report from a rural DOTS programme in south India. Int J Tuberc Lung Dis 2004; 8(3):323–332.
18. Jakubowiak WM, Bogorodskaya EM, Borisov ES, Danilova DI, Kourbatova EK. Risk factors associated with default among new pulmonary TB patients and social support in six Russian regions. Int J Tuberc Lung Dis 2007; 11(1):46– 53.
19. Chatterjee P, Banerjee B, Dutt D, Pati RR, Mullick AK. A complete evaluation of factors and reasons for defaulting in tuberculosis treatment in the state of West Bengal, Jharkhand and Arunachal Pradesh. Indian J Tuberc, 2003,50:17-22.
20. Tekle B, Mariam DH, Ali A. Defaulting from DOTS and its determinants in three districts of Arsi Zone in Ethiopia. Int J Tuberc Lung Dis 2002; 6(7):573–579.
21. Gopi PG, Vasantha M, Muniyandi M, Chandrasekaran V, Balasubramanian R, Narayanan PR. Risk factors for nonadherence to directly observed treatment (dot) in a rural tuberculosis unit, South India. Indian J Tuberc 2007; 54:66-70.
22. Chang KC, Leung CC, Tam CM. Risk factors for defaulting from anti-tuberculosis treatment under directly observed treatment in Hong Kong. Int J Tuberc Lung Dis 2004; 8(12):1492–1498.
23. Hasker E, Khodjikhanov M, Usarova S, Asamidinov U, Yuldashova U, Werf MJ. Default from tuberculosis treatment in Tashkent, Uzbekistan; Who are these defaulters and why do they default? BMC Infectious Diseases 2008; 8:97.
24. Zellweger JP, and Coulon P. Outcome of patients treated for tuberculosis in Vaud County, Switzerland. Int J Tuberc Lung Dis 1998; 2(5): 372-77.
25. Santha T, Garg R, Frieden TR, Chandrasekaran V, Subramani R, Gopi PG et al. Risk factors associated with default, failure and death among tuberculosis patient treated in a DOTS programme in Tiruvallur district, South India, 2000. Int J Tuberc Lung Dis. 2003 Feb;7(2):200-1.
26. da Silva Oliveira VL, da Cunha AJLA, Alves R. Tuberculosis treatment default among Brazilian children. Int J Tuberc Lung Dis 2006; 10(8):864–869.