Smear Conversion, Treatment Outcomes and the Time of Default in Registered Tuberculosis Patients on RNTCP DOTS in Puducherry, Southern India.

Abstract

Revised National Tuberculosis Control Programme (RNTCP) in India has achieved improved cure rates. This study describes the achievements under RNTCP in terms of conversion rates, treatment outcomes and pattern of time of default in patients on directly observed short-course treatment for Tuberculosis in Puducherry, Southern India. Retrospective cohort study; Tuberculosis Unit in District Tuberculosis Centre, Puducherry, India. Cohort analysis of patients of registered at the Tuberculosis Unit during 1(st) and 2(nd) quarter of the year 2011. Details about sputum conversion, treatment outcome and time of default were obtained from the tuberculosis register. Kaplan-Meier plots & log rank tests. RNTCP targets with respect to success rate (85.7%), death rate (2.7%) and failure rate (2.1%) in new cases have been achieved but the sputum conversion rate (88%) and default rate (5.9%) targets have not been achieved. The overall default rate for all registered TB patients was 7.4%; significantly higher in category II. In retreatment cases registered as treatment after default, the default rate was high (9%). The cumulative default rate; though similar in the initial two months of treatment; was consistently higher in category II as compared to that in category I. Nearly 40% of all defaulters interrupted treatment between the second and fourth month after treatment initiation. Defaulting from treatment is more common among the retreatment cases and usually occurs during the transition phase from intensive phase to continuation phase.