Sociodemographic profile and treatment outcome of tuberculosis patients registered under directly observed treatment short course in East Sikkim with reference to defaulters

Abstract

Background: India has the highest burden of tuberculosis (TB) despite it being one of the oldest diseases. Defaulting from antitubercular therapy is one of the challenges in the control of TB. Objectives: To study the sociodemographic profile and outcome of TB patients registered under Directly Observed Treatment Short course (DOTS) in East Sikkim from 2009 to 2011, with reference to defaulters. Methods: In this cross-sectional study, primary data were obtained by interviewing defaulters (only 32 out of total 46 defaulters). Secondary data for all defaulters were obtained from district TB registers. Data were entered into excel sheet and analyzed (Limitation of the study: All 46 defaulters could not be interviewed). Results: The defaulters were more commonly from category II of DOTS with an equal male:female ratio with most common age group of defaulters being 20–39 years. The most common timing of default was the early intensive phase and the early continuation phase. The reasons for default were usually multiple in most with consumption of alcohol, relief of symptoms, and migration being the most common. Out of the 46 defaulters, 10 patients were retrieved back, 5 patients were started on non-DOTs therapy, 7 patients expired, 8 patients migrated out, 10 patients were lost to follow-up, and rest 6 patients could not be traced. Conclusions: Causes of default are usually multiple, and most cases are preventable/rectifiable. Some flexibility with respect to drug administration and strengthening in DOTS program by reviewing it at regular intervals will go a long way in further.