Abstract
Early case identification and prompt treatment of new sputum smear positive case are important to reduce the spread of tuberculosis (TB). Present study was planned to study the associated factors for duration to contact the health facility since appearance of symptoms and treatment default. Methodology. It was prospective cohort study of TB patients already registered for treatment in randomly selected TB units (TUs) in Himachal Pradesh, India. Relative risk (RR) was calculated as risk estimate to find out the explanatory variables for early contact and default. Results. Total 1607 patients were recruited and 25 (1.5%) defaulted treatment. Patients from nuclear family (aRR: 1.37; 1.09–1.73), ashamed of TB (aRR: 1.32; 1.03–1.70), wishing to disclose disease status (aRR: 1.79; 1.43–2.24), but aware of curable nature (aRR: 1.67; 1.17–2.39) and preventable (aRR: 1.35; 1.07–1.70) nature of disease, contacted health facility early since appearance of symptoms. Conclusion. Better awareness and less misconceptions about disease influences the early contact of health facility and low default rate in North India.
Highlights
One-third of the world population is infected with Mycobacterium tuberculosis causing disease in about 10 million individuals and resulting in 1.3 million deaths per year
Treatment success rate among sputum smear positive patients improved from 25% in the year 1985 to about 90% by the year 2011 [2] as compared to the global treatment success rate of 84% [1]
The number of defaulted patients was small to look for statistically significant difference, but most of patients (76.0%) thought that TB and its treatment affect their work performance, 56.0% hid their disease status from others, and 52.0% did not disclose their disease status to their family members
Summary
One-third of the world population is infected with Mycobacterium tuberculosis causing disease in about 10 million individuals and resulting in 1.3 million deaths per year. Evidence from India showed that tuberculosis (TB) contributes about 30% of deaths due to communicable disease and 7% of total deaths [2]. Based upon World Health Organization (WHO) recommendations, the Government of India implemented Directly Observed Treatment Short Course (DOTS) strategy under Revised National Tuberculosis Program (RNTCP) [2]. Under RNTCP, an awareness campaign for signs and symptoms of TB demands an early contact of health facility for diagnosis. Contact of patient to health facility for treatment compliance depended on the program and patient related factors [3,4,5]. The nature and degree of influence of such factors on health facility contact and so compliance for DOTS have not been reported as often. The present study was planned to understand the role of factors in contacting
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