Performance and treatment outcome of tuberculosis among patients on Revised National Tuberculosis Control Programme in Urban and Tribal areas of a district in Maharashtra

Abstract

Background: Revised National Tuberculosis Control Programme (RNTCP) was introduced in the country as a pilot project since 1993 in a phased manner and expanded throughout the country by the year 2005. Although studies have shown the success of RNTCP, data pertaining to the indicators of programme performance in urban and tribal set up are rare. Objectives: The objective of this study was to assess and compare the RNTCP in urban and tribal areas of Maharashtra through the indicators of performance and outcome of the patients. Patients and Methods: A retrospective comparative record-based study was conducted in selected urban and tribal areas' tuberculosis (TB) units. Records of patients enrolled newly for TB treatment and those already undergoing treatment under RNTCP from April 2015 to September 2015 (6 months) were considered for analysis. Chi-square test and Z-test (test of significance) are applied where required by using Epi Info 7 and Microsoft Excel 2010.Results: Sputum smear collection was significantly higher in urban areas (P = 0.001). In urban areas, new TB case detection was 35%, while in tribal areas, it was 42% as per the RNTCP norms. Sputum positivity was marginally more in tribal (5.87%) than urban (3.28%) areas. Cure rate was more in urban areas than tribal (P = 0.001) areas. There were statistically significantly high default cases in tribal areas. Conclusions: Sputum collection and sputum positivity rate were low in urban and tribal areas, but TB screening, especially in tribal areas, was significantly low. Sputum positivity was significantly higher in tribal areas. Significantly low cure rate and high default rate in tribal area warrant the need for strengthening of RNTCP activities in tribal areas.