Current status of timing of treatment interruption and pattern of default among tuberculosis patients on directly observed treatment

Abstract

Background: Default remains an important challenge and a threat for tuberculosis (TB) control. Aims and Objectives: Objectives of the study were to analyze timing of treatment interruption and pattern of default among TB patients on directly observed treatment, short-course under Revised National Tuberculosis Control Programme. Materials and Methods: The present cross sectional study was conducted among the cohort of patients registered during January 2011 to September 2011 at the Tuberculosis Unit, Ambala city. Number of interruptions/doses missed, number, and timing of default were taken from TB register and treatment cards. Results: Out of 80 defaulters, majority (50,62.5%) defaulted in the continuation phase of treatment. Out of these 50 patients, 31 were new and remaining 19 were from previously treated categories. In category I, maximum default was seen in the third month of treatment ( 2.84%). The cumulative default rate at the end of second month was 2.57%. The default rate at the end of the eighth month, when all patients were censored, was 8.18%. In category II, maximum default (3.61%) occurred in the fourth month. The cumulative default rate by the end of third month was 13.92%; and by the end of eighth month, 21.76%. The default rate by the end of the tenth month, by which time all patients were censored, was 21.76%. Conclusions: Patient defaulting from treatment remains a matter of concern. Factors behind higher default rate in continuation phase need to be explored. Default in intensive phase of treatment and without smear conversion at the end of intensive phase should be retrieved on a priority basis.