Directly Observed Treatment Short Course Centers Research Articles

Prevalence, Patterns and Peculiarities of Depression among Tuberculosis Patients Attending Directly Observed Treatment Short-course (DOTS) Centers in Lagos State Nigeria

Tuberculosis (TB) is an infectious disease that is life-threatening to vulnerable populations, and has been reported to be associated with depression. Nigeria is one of the countries with a high TB burden, and with the current economic hardship in Nigeria, people are becoming poorer suggesting more TB patients are more likely to elapse into depression. The aim of this research was to assess the prevalence, patterns and peculiarities of depression among TB patients attending Directly Observed Treatment Short course (DOTS) centers in Lagos State, Nigeria. A descriptive, cross-sectional survey was conducted among 301 TB patients at 8 DOTS centers in Lagos State, Nigeria using a two-stage sampling method. Data was collected using interviewer-administered questionnaires to elicit responses from the TB patients. Patient Health Questionnaire-9 (PHQ-9) was used to determine and assess depression. Data was analyzed using SPSS version 23.0, with the Chi-square test being used to check for the association between socio-demographic characteristics and depression among the respondents. Mean age of the respondents was 35.1±11.7 years. A majority (71.8%) of the respondents were males, 69.1% were Christians, Yorubas were most (52.2%), 88.4% earned ≤N150,000 monthly, and only 1 respondent had no formal education. The prevalence rate of depression among the TB patients was 51.8%. Socio-demographic characteristics like gender (females were more affected), low financial status, and low educational level were associated with depression (p<0.05); unlike age, marital status, ethnicity, employment status, and family setting (p>0.05). Depression among TB patients is real as one in every two TB patients is depressed. Therefore, healthcare workers at DOTS centers should pay adequate attention to signs of depression among their patients.

Improving treatment adherence among tuberculosis patients through evening DOTS in Chennai, India.

Background Fixed days and timings of service are challenges in the care of patients with tuberculosis (TB). We assessed whether provision of evening DOTS (directly observed treatment, short course) improves treatment outcomes in a city with a working population. Methods We enrolled new adult patients with TB from seven tuberculous units (TUs) in this prospective cohort study. Participants were offered the option of DOTS during the day (8 a.m. to 3:30 p.m.) or evening (4 p.m. to 8 p.m.) and assigned accordingly. Results Of 127 patients enrolled between April and July 2017, 19 (15%) opted for evening DOTS. The number varied between the seven TUs (p=0.002). On an average, antitubercular therapy (ATT) was taken at 9:41 a.m. in the routine and 5:14 p.m. in the evening DOTS centres. Patients who were employed, left residence and returned back at 9:05 a.m. and 6:40 p.m., respectively. Around 96% (104/108) opted for day-time DOTS due to closeness of the centre to their residence. Around 74% (14/19) chose evening DOTS because of time convenience. Around 15% of patients on routine DOTS (16) had unfavourable treatment outcomes. All had favourable outcomes in the evening DOTS. Men were less likely and those withut alcohol disorders were more likely to have treatment success. Conclusion Provision of time convenient services might improve adherence and treatment outcome.

Tuberculosis preventive practices among treatment supporters in Lagos, Nigeria.

Tuberculosis (TB) treatment support is one of the recommended strategies to enhance treatment adherence and outcomes. Treatment supporters are at risk of contracting TB and adequate knowledge of TB and good preventive practices are required for their protection. This study aimed at assessing the knowledge and preventive practices of TB treatment supporters at Directly Observed Treatment Short-course (DOTS) centers in Lagos Mainland Local Government Area of Lagos state, Nigeria. This cross-sectional study was conducted among 196 TB treatment supporters selected from five DOTS centers in Lagos. Data were obtained using an adapted pretested questionnaire. Bivariate and multivariate analyses were performed to determine the factors associated with self-protection practices. A P < 0.05 was considered statistically significant. The mean age of the participants was 37.3 ± 12.1 years. More than half of the respondents were females (59.2%) and immediate family members (61.3%). Overall, 22.5% had good knowledge of TB, while 53.0% had positive attitudes toward TB. Only 26.0% adequately protected themselves from infection. The caregiver's level of education (P = 0.001) and their relationship to the patient (P = 0.001) were significantly associated with good preventive practices in bivariate analysis. Not being related to the patient was a predictor of adequate TB prevention practices (adjusted odds ratio = 2.852; P = 0.006; 95% confidence interval = 1.360-5.984). This study revealed low levels of TB knowledge and fair preventive practices, especially among caregivers who are relatives. There is, therefore, a need to improve population literacy about TB and its prevention and a more focused orientation of relatives who volunteer as treatment supporters, through health education, with periodic monitoring during clinic visits, of how they prevent TB.

The burden of TB/HIV co-infection among clients attending DOTs clinic in a tertiary centre in Southwestern, Nigeria: A 5-year retrospective study.

Tuberculosis (TB) and human immunodeficiency virus (HIV) are closely correlated and continue to cause deleterious effects in co-infected patients. This study aimed to determine the prevalence and associated factors of TB/HIV co-infection among directly observed treatment short-course (DOTs) clinic clients in Ogun State, Nigeria. The TB register and treatment cards of patients that visited the DOTs centre in Federal Medical Centre Abeokuta between January 2015 and December 2019 were reviewed. A total of 726 TB patients' records were reviewed, among which 186 (22.5%) were co-infected with HIV. TB/HIV co-infection was significantly associated with the ⩽19 years age group 54 (37.2%), females 85 (26.7%), divorced and separated 8 (34.8%), rural residents 18 (34.0%), those who had no formal education 53 (39.8%) and the unemployed 63 (31.7%). Gender and educational status remained significant predictors of TB/HIV co-infection after adjustment for confounding factors. Gender-sensitive programming and interventions geared towards improving knowledge of TB and HIV using a wide array of approaches should be considered.

Compliance of patients to DOTS tuberculosis treatment strategy in a South-East Nigeria Teaching Hospital.

Tuberculosis ranks the second highest cause of adult mortality after HIV in the world. The Directly Observed Treatment Short course (DOTS) strategy is aimed at following up on patients' adherence to treatment regimen. To assess the level of compliance of patients to the DOTS strategy. A retrospective study of patients seen at the University of Nigeria Teaching Hospital from January, 2013 to April, 2015. Relevant information was collected from patients' folders. Data analysis was with the SPSS and results represented in tables. 111 (50%) patients were compliant with their DOTS treatment plan while 107 (41.3%) were non-compliant. Ninety-two patients (41.4%) were successfully treated and discharged home, 7 patients (3.2%) referred to other centres. The proportion of patients regarding their marital status, occupation, educational level and address that was compliant to the DOTS TB reflected varied patterns. The study reflected poor to average compliance to DOTS. There is a need for creation of more DOTS centres; regular surveys and updates on DOTS TB strategy should be the norm rather than the exception.

Evaluation of ‘Referral for Treatment’ System under RNTCP in a Hospital at Kolkata, India

To handle the problem of tuberculosis (TB), Government of India started the Revised National TB Control Programme (RNTCP) in 1993, whereby Directly Observed Treatment, Short-course (DOTS) was officially adopted as the strategy in 1997. The medical colleges, involved in the RNTCP programme, refer the patients to the DOTS centres near their homes, after assigning the treatment categories. This study attempts to evaluate this ‘referral for treatment’ system during the second phase of RNTCP (RNTCP-II). To achieve this objective, pertinent data regarding 758 patients referred from RG Kar Medical College, Kolkata, to various DOTS centres in West Bengal, between 01.10.2006 and 30.09.2007, were collected from the said medical college, the relevant DOTS centres, the patients themselves, using a suitable questionnaire, and also the family members and the neighbours of some patients. Chi-square test at 5% level of significance was used as an analysis tool.

Facilitators and Barriers to Implementation of a Childhood Tuberculosis Control Program in Bangladesh: A Mixed-Methods Study from BRAC Urban DOTS Centres in Dhaka.

The case detection rate of childhood tuberculosis in Bangladesh is 4%, far below the World Health Organization predicted rate of 10–15% for a country with a high burden of tuberculosis. A concurrent triangulation mixed-methods study was carried out in eight urban DOTS (Directly Observed Treatment, Short-course) centres to investigate the factors contributing to the diagnosis and treatment of childhood tuberculosis. Front-line health care workers (Shasthya Shebika) (n = 111) were surveyed to understand knowledge, attitude, and practice (KAP) of the diagnosis and treatment of childhood tuberculosis. In-depth interviews were conducted with field workers (n = 32) and mothers of TB cases (n = 4). Stakeholders involved in implementing the tuberculosis program (n = 9) participated in the key informant interviews. Knowledge of Shasthya Shebika was associated with the components addressed during refresher training (p = 0.02). Government stewardship, presence of specific guidelines, knowledge and capacity building of front-line health workers were identified as the key facilitators. Frequent turnover of key managerial positions in the government, stigma, delays in seeking care, lack of diagnostic facilities, and poor engagement of private practitioners were identified as major constraints. It was identified that the government should focus on improving diagnostic capacities, conduct research on childhood tuberculosis, and produce awareness materials.

Determinants of tuberculosis patients attending Directly Observed Treatment Short course (DOTS) centre for prevention of default in TB treatment

Introduction: It was necessary to understand the reasons for default after initiation of the treatment and plan strategies to reduce default and thereby increase the success of treatment outcome. Materials and Methods: The present observational cross-sectional study was carried out in selected DOTS centers of district Ghaziabad Department of Community Medicine, Santosh Medical College, Ghaziabad. All new sputum smear positive pulmonary tuberculosis patients were taking treatment from sampled DOTS Centers. The study was carried out in one year from May 2014 to April 2015. Results: 45.7% tuberculosis patients were unemployed. 35.29% of TB patients were educated up to primary 24.70% pt were illiterate. 54.11% of TB patients belong to upper lower class. 34.11% were in lower class. Among the TB patients 76.47% were smoker whereas 23.53% were non smoker. Among the TB patients 77.65% were alcoholic whereas 22.35% were non alcoholic. 83.53% TB patients had no family h/o of contact while 16.47% TB patients had Family h/o of contact. Among tuberculosis patients 77.65% were aware about the curability of tuberculosis while 22.35% were not aware about the curability of TB. 34.12% patients were aware about Modes of Transmission of Tuberculosis and 65.88% TB patients were not aware about Modes of Transmission of Tuberculosis. Conclusion: It was concluded that socioeconomic standard of tuberculosis is low and give health education to improve personal habit and stop TB Transmission. Awareness about modes of transmission of tuberculosis was low. Awareness about curability of tuberculosis and knowledge and proper treatment of pulmonary Tuberculosis is poor. Keywords: curability, DOTS Centre, mode of transmission, occupation, socioeconomic status, TB patients.

Socio-demographic determinants of tuberculosis patients attending directly observed treatment short course centre in urban Ghaziabad, Uttar Pradesh

Background: Tuberculosis was the first infectious disease declared by the WHO as a global health emergency. Men are more commonly affected than women. The case notifications were higher in males than in females most countries. The objective of the study was to assess socio-demographic determinants of tuberculosis patients attending directly observed treatment short course (DOTS) centre in Urban Ghaziabad.Methods: This was an observational cross-sectional study. The study was carried out in selected DOTS centres of district Ghaziabad. 850 study subjects age group more than 15 years were included. Multistage sampling was done. Numbers and percentage were used. SPSS version 13 was used for statistical analysis.Results: Majority 41.17% of tuberculosis (TB) patients belonged to 15-25 years age group. 30.58% patients were in 26-35 years age group followed by 23.52% in 36-45 years age group and least 4.70% were in &gt;45 years age group. Majority 54.1% of TB patients were females that compared to 45.9% were males. Among tuberculosis patients majority 58.82% were married as compared to 40% were unmarried and least 1.18% were widow. 75.29% tuberculosis patients were Hindus as compared to 22.35 were Muslims and least 2.35% were Sikh/Christian. Among tuberculosis patients majority 44.71% were from nuclear family. 31.76% had joint family and least 23.53% had 3rd generation family.Conclusions: It was concluded that socio-demographic determinants were low. It was recommended to raise socioeconomic standard of population, give health education to improve personal habit and stop TB transmission.

Adverse drug reactions in patients taking anti tuberculosis therapy from directly observed treatment short course centre at Mandya Institute of Medical Sciences, Mandya: a cross sectional study

Background: Ending the tuberculosis (TB) epidemic by 2030 is among the health targets of the sustainable development goals. Side effects to anti-TB drugs are common and may lead to reduced compliance to treatment. These adverse effects must be recognized early to reduce associated morbidity and mortality. Objective of this study was to determine the adverse drug reactions (ADR) to anti-tubercular therapy among patients visiting directly observed treatment, short-course (DOTS) centre MIMS, Mandya.Methods: A cross sectional study was conducted at DOTS Centre MIMS, Mandya. TB patients registered at DOTS Centre during the year 2018 were selected for the study. Verbal informed consent was taken from the TB patients and interviewed using pretested semi-structured questionnaire. Data analysis was done using descriptive statistics and chi square test.Results: Among the study population (n=90), 67 (74.4%) experienced ADR among which 47.7% took treatment for ADR and the remaining 52.3% patients were given reassurance. In this study, gastrointestinal manifestations (42.3%) were the most common adverse drug reaction (ADR). Of the TB patients who experienced ADR, 9.0% of them had interrupted ATT, however they completed full course of ATT.Conclusions: A considerable number of TB patients taking ATT experience ADRs and some of them may have to interrupt treatment. However, they need to be counselled or supervised with caution to complete their course of treatment to reduce the chances of treatment default and also reduce the occurrence of drug resistance.

Social stigma among tuberculosis patients attending DOTS centers in Delhi.

Background:Every year >9 million people suffer from tuberculosis (TB) and India accounts for >25% of global TB burden. Tuberculosis patients experience both psychological and social suffering. Amongst the problems met by tuberculosis patients, social stigma has been increasingly recognized. This study was done to assess social stigma and associated factors among the tuberculosis patients attending Directly Observed Treatment Short-course (DOTS) centers in South East Delhi.Material and Methods:It was a cross-sectional study carried out among tuberculosis patients availing treatment from DOTS centers of South East Delhi. Out of 48 DOTS centers in South East Delhi, 6 centers were selected on the basis of population proportion to size. A total of 270 TB patients were interviewed using a semi-structured, pretested questionnaire consisting of stigma-based questions. Fisher exact and Chi-square test applied.Results:The mean age of patients was 31.5 years (SD ± 11.5) with age ranging from 18 to 77 years. Males were higher (57.4%) compared to females (42.6%). 123 (45.5%) perceived stigma with family/friends and 92/158 (58.2%) perceived stigma at workplace. Young patients (<30 years), males faced more stigma at workplace and lower socioeconomic class faced higher stigma with family and friends (P < 0.05).Conclusion:There is still higher stigmatization faced by patients with TB at family/friends and at workplace. Motivation by friends/family and support at workplace has been crucial in achieving successful treatment outcomes.

Contribution of community pharmacy in treating tuberculosis: A pharmacy centric study from Belagavi district

Introduction: Tuberculosis (TB) is an important global health problem, which is aimed to be eradicated by 2025 from India. Community pharmacists play a significant role in treating and eradication of TB. This study aimed to understand the contribution of community pharmacy and their potential role in RNTCP (Revised National TB Control Programme) functioning. Materials and Methods: The study was conducted at Belagavi, Karnataka, India on 312 community pharmacies. A structured interview form was used to assess several factors such as education, knowledge, anti-TB drug dispensing patterns, willingness to be trained, and become a DOTS (Directly Observed Treatment Short course) provider. Results: On an overall scale, we found that the majority of licensed community pharmacy was managed by D. Pharm holders with a limited knowledge of TB. It was also noted that there was a lack of willingness to be rigorously trained for updating their knowledge, although they were interested in being trained for being recognized as a DOTS center. Conclusion: There is a strong need for strengthening community pharmacy services in tune with RNTCP to achieve better efficiency in treating and eradication of TB.

Depression among TB patients and associated factors in Kathmandu Valley, Nepal.

When tuberculosis (TB) and depression co-occur, there is greater risk for comorbidities, disability, suffering, and health-related costs. Depression is also associated with poor treatment adherence in patients with TB. The major aim of this study was to assess the symptoms of depression and associated factors among TB patients currently receiving directly observed treatment short-course (DOTS) treatment. A cross-sectional study was conducted among TB patients currently undergoing treatment in 27 DOTS centers in three districts of Kathmandu Valley. The study included 250 TB patients within 2 months of treatment initiation, aged 18 years and above. The previously validated Nepali Patient Health Questionnaire (PHQ-9) was used to screen for depression and semi-structured interviews were conducted to collect socio-demographic information and other factors related to TB and/or depression. Data analysis was conducted using IBM SPSS Statistics version 20. The study found the mean PHQ Score to be 2.84 (s.d. 4.92, range 0-25). Among the respondents, 10% (n=25) had PHQ-9 scores ⩾10, suggestive of probable depression. Multivariate linear regression indicated that depressive symptoms were significantly associated with being separated/widowed/divorced (p=0.000) and having lower education (0.003). In addition, smoking (p=0.02), alcohol use (p=0.001), and experience of side effects from TB medications (p=0.001) were risk factors for higher PHQ-9 scores. Our findings suggest that patients on TB treatment have higher risk of depression and efforts should be made by the National Tuberculosis Program to address this issue.

Profile of tuberculosis cases attending a directly observed treatment short-course centre in North Kerala

Background: Tuberculosis (TB) is a worldwide public health problem. India has the highest TB burden in the world. India accounted for a quarter of global incident TB cases, 24% of multi drug resistance (MDR) TB cases and highest TB mortality rate in 2017. Thus it is important to understand the profile of TB patients. The objective of the study was to assess the profile of TB cases attending a directly observed treatment short-course (DOTS) center in North Kerala.Methods: A retrospective record based, descriptive study was done in the DOTS center of Government Medical College Kannur, in North Kerala, to assess the profile of TB patients who attended the centre from January 2015 to July 2018. Details of 548 patients were collected from the record maintained at DOTS center. Data was entered in Microsoft Excel and analysed using Epi info7 software.Results: The age group of 21-60 years was most affected. 68.53% of the patients were males. 45.62% of patients had extra-pulmonary TB (EPTB). Among the pulmonary TB patients, 74.27% tested positive for acid fast bacilli. Among cases of EPTB, most common type was TB lymphadenitis (40.8%) followed by tuberculous pleural effusion (22.4%). 87.59% of TB patients were started on category I treatment under DOTS.Conclusions: In our study, affected population was mostly males and those in productive age group. This is the group that has maximum chances of exposure to TB patients. 45.62% patients had EPTB. Total number of cases is on the rise each year, with maximum cases in 2018.

Compliance to Directly Observed Treatment Short Course (DOTS) Chemotherapy among the Patient of Pulmonary Tuberculosis in Banke District of Nepal

Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. High bacterial infectivity, transmissibility, increasing drug resistance and non compliance to the therapy have been adding up challenges to prevention and control of tuberculosis. This study was conducted to observe the treatment compliance pattern among new pulmonary sputum smear positive cases of tuberculosis. A cross sectional study was carried out in the year 2009. The 114 new smear positive pulmonary tuberculosis patients registered in the six selected DOTS centres of the Banke Disrtict were randomly selected. Participants were selected from each DOTS centre by probability proportionate sampling methods. Data were analyzed by SPSS (11.0 Version) and P&lt; 0.05 was considered as significant. Overall compliance to DOTS was 86.80 percent; of these, 57.00 percent showed excellent and regular compliance followed by nearly 30 percent good compliance. And 13.20 percent participants were non complaint to DOTS therapy. Positive Family behaviors were positively associated with compliance while alcohol consumption was found to be negatively associated with compliance however; age, sex and income were found to be non significant factors for compliance. Feeling of getting cure even before the course of DOTS therapy (feeling better after 2-3 months regular treatment) and drinking habits were found to be the major causes of non compliance. Supportive family behaviors and avoidance of alcohol consumption may promote the compliance. Excellent treatment compliance in the face of many odds is highly encouraging and the pattern can be useful in treatment despite little non compliances; furthermore compliance can be enhanced by acting on these causes of non compliances.&#x0D; Key words: Pulmonary, Tuberculosis, DOTS, Banke, Nepal

Treatment outcome of tuberculosis patients under directly observed treatment short-course and factors affecting the outcome in tertiary care hospital

Background: Revised National Tuberculosis Control Programme (RNTCP) based on Directly Observed Treatment Short-course (DOTS) strategy has been made available in entire country by March 2006. Given high rate of unfavourable treatment outcomes reported in some provinces, there is a need to analyse outcomes and identify possible trends and associated risk factors that can help for improvement in RNTCP.Methods: After getting Institutional Ethics Committee (IEC) approval, total of 76 cases diagnosed and treated for Tuberculosis (TB) under Category I of RNTCP were recruited from January to March 2017. All patients were followed up for six months from date of initiating the treatment. The data was obtained from TB treatment register, by patient visit and regular follow-up. The information collected include age and gender of patient, category of treatment, date of treatment initiation, initial sputum conversion, outcome of treatment and date of outcome.Results: Out of total 76 patients, 64 (84.21%) were cured, 5 (6.57%) were lost to follow-up, 4 (5.26%) were failed to treat, 1 (1.32%) patient was died, 1 (1.32%) patient had completed treatment but status was unknown and 1 (1.32%) patient was not evaluated because of transfer. Overall treatment outcome of TB patients under DOTS was matching goal of RNTCP with cure rate of 84.21%.Conclusions: Efforts by DOT providers, adequate patient education, motivating ones in need can bring positive outcomes. In this region, DOTS center is at good working condition in terms of functionality as well as ethically. Gender, age group, residence and initial culture colony did not significantly affect treatment outcome.

Delay in initiation of treatment of tuberculosis: A cross-sectional study from rural Wardha

Background: India with 2.2 million incident cases annually contributed to around 25% of global incidence. Along with conventional indicators, magnitude of treatment delay would prove as a performance indicator for tuberculosis (TB) control in high TB burden countries like India. Objectives: The objectives of the study were to find out the magnitude of treatment delay among the TB patients, to describe the factors responsible for delay in treatment, if any, and to assess the knowledge of patients in a rural area about TB and directly observed treatment short course (DOTS). Study Design: Descriptive cross-sectional study was conducted among patients registered in the DOTS center at Mahatma Gandhi Institute of Medical Sciences Sewagram. Materials and Methods: Information of all 40 new sputum smear-positive TB patients registered at DOTS center between February and April 2015 was collected. Of these, thirty patients could be contacted successfully and were included in the study after obtaining consent. Data were entered in Microsoft Excel and analyzed using Epi Info software. Mean and median delay in terms of days were estimated. Mann–Whitney U-test was used to determine factors associated with treatment delay. Descriptive analysis using frequency and percentage was carried out to assess the knowledge regarding TB and DOTS. Results: Median delay was 35.5 days with diagnostic delay comprising 84% of it. Male patients and patients belonging to Below Poverty Line (BPL) families had significantly (P

Tuberculosis among School Age (6 - 18 Years) Children Seen in University of Port Harcourt Teaching Hospital: A Need for Effective School Health Services

Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.

Epidemiological profile of tuberculosis patients in Delhi, India: A retrospective data analysis from the directly observed treatment short-course (DOTS) center.

Background:Tuberculosis (TB) has been a public health menace for decades. India harbors its highest burden globally. The present study was conducted to study the epidemiological profile of patients taking treatment from a directly observed treatment short-course (DOTS) center in Delhi, India.Method:Retrospective analysis of past 1-year treatment records of a total of 227 patients undergoing treatment in DOTS since June 2014–2015 was undertaken. Socio-demographic information, data related to disease status, and HIV testing were collected and analyzed.Results:The majority of cases were new (77.1%) and pulmonary TB (69.2%). The highest disease burden was found in the 20–60 year age group (72.2%) and males (58.6%). Genitourinary TB was present only among females. None of the patients was HIV positive. A significant association was found between the age group of 20–60 years and relapse and loss to follow-up cases (P < 0.05).Conclusions:A higher proportion of adult males aged 20–60 years constituted the majority of patients treated in the DOTS center. Focussed interventions can be designed for this age group in future public health policies to reduce disease burden in the total population. Further research is required to be undertaken in exploring reasons for higher prevalence among males and productive age group and role of age, gender in disease causation

Client satisfaction and its correlates of directly observed treatment short course therapy in a tuberculosis unit of Bankura, West Bengal

Background: Tuberculosis (TB) is a curable disease still millions of people suffer and many of them die from this disease. Just providing anti-TB medication is not sufficient to ensure that patient to be cured. Objective: The objective of this study is to assess the treatment outcome rates and to find out the determinants of patient satisfaction. Materials and Methods: A clinic-based, descriptive, crosssectional study was conducted in Lokepur Tuberculosis unit (TU) from July 2015 to June 2016. Simple random sampling was adopted to select 50% of the Directly Observed Treatment Short Course (DOTS) centers under that TU. Afterward, complete enumeration of the adult TB patients receiving Category I treatment and registered from June to October 2015 was done from the selected DOTS centers. Exit interview of the patients was conducted using pretested predesigned questionnaire and treatment outcomes were recorded from TB register. Data were entered in MS Excel Spreadsheet and analyzed by SPSS 22.0 version. Results: Treatment success rate of Category I TB patients was about 87%. Almost 76% patients were satisfied with the given services. Treatment success rate was higher among the satisfied (97%) than the not satisfied (57%) clients and the difference was statistically significant. Client satisfaction was statistically associated with gender, residence, educational level, first caregiving person, and decision maker in getting treatment. Conclusion: Concern given to urban slum areas, improvement of literacy status of the patients, arrangement of the alternative sources of income for TB-affected family, and improvement of the knowledge of first caregiving persons are the steps to be taken at this hour.