scholarly journals A study on non-compliance in tuberculosis cases towards the directly observed treatment short course under RNTCP in Kanpur Nagar

2017 ◽  
Vol 4 (12) ◽  
pp. 4485 ◽  
Author(s):  
Kuldeep Srivastava ◽  
Abhishek Gupta ◽  
Ruchi Saxena ◽  
R. P. Sharma ◽  
Tanu Midha
Keyword(s):  
Symptomatic Relief ◽  
Compliance Rate ◽  
Treatment Compliance ◽  
Sampling Technique ◽  
Control Programme ◽  
High Rate ◽  
Class Iii ◽  
Skilled Workers ◽  
Short Course ◽  
Directly Observed Treatment

Background: The goal of Revised National Tuberculosis Control Programme (RNTCP) is to achieve cure rate of at least 85% and to detect at least 70% of the new smear positive cases of tuberculosis (TB). A very high rate of compliance to treatment is required to achieve the target and to prevent the drug resistance. The objective of the study was to study the magnitude and reasons of non-compliance in TB patients towards directly observed treatment short course (DOTS) in Kanpur Nagar.Methods: Multistage random sampling technique was used to select the study subjects from the two designated microscopy centres (DMC). Information regarding treatment compliance and patient satisfaction was elicited and recorded in the predesigned and pretested questionnaire, analysis was done using SPSS and  percentages was used to draw the results.Results: Out of total 300 study subjects, 41(13.67%) were non-compliant during treatment. Majority of non-compliant study subjects were aged more than 50 years (30.23%), skilled workers (29%), belonged to socioeconomic class III (22.9%), Muslims (19.36%) and educated upto high school (16.33%). The most common cause of non-compliance in the present study was symptomatic relief during treatment (73.20%) followed by intolerance to medications (24.40%).Conclusions: Compliance to the drug regimen under RNTCP plays a vital role in the cure of the TB cases. Non-Compliance rate being high in the present study, health education of the community at large and regular follow up of all defaulters, to find out the reasons for default and measures to reduce them, requires more emphasis to achieve the goal of RNTCP. 

scholarly journals Patient’s satisfaction regarding directly observed treatment short course under RNTCP in a district of North India

2017 ◽  
Vol 4 (5) ◽  
pp. 1536 ◽  
Author(s):  
Kuldeep Srivastava ◽  
Abhishek Gupta ◽  
Ruchi Saxena ◽  
R. P. Sharma ◽  
Tanu Midha
Keyword(s):  
Treatment Compliance ◽  
Sampling Technique ◽  
North India ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Duration Of Treatment ◽  
Patient’S Satisfaction ◽  
Short Course ◽  
Directly Observed Treatment ◽  
To Come

Background: In 2015, RNTCP covered a population of 1.28 billion. A total of 9132,306 TB suspects were examined by sputum smear microscopy and 14, 23, 181 cases were registered for treatment. Most peripheral unit under the RNTCP network is the designated microscopy centre (DMC) which serves a population of around 100,000 (50,000 in tribal and hilly areas). Treatment compliance and patients satisfaction is important concern for quality service success of RNTCP. Objectives of this study were to assess the treatment compliance and patient’s satisfaction regarding directly observed treatment short course chemotherapy (DOTS).Methods: It was an observational study conducted among DMCs of Kanpur district. Multistage random sampling technique was used for selection of DMC in both rural and urban area. 300 subjects interviewed in this study.Results: Most of the study subjects (87%) were satisfied with the services provided at the DMC. Compliant status was better in rural DMC (94.50%). Non-compliance was more in urban DMC (18.4%). Majority of the study subjects (67%) were satisfied due to availability of free medicines at the centres. Difficulty to come on alternate days was the most common reason for dissatisfaction among study subjects (43.6%) followed by wastage of time (23.1%).Conclusions: About 13 percent patient was not satisfied with DMC services. Among urban DMCs 18.4 percent patient were not compliant where it was 5.5 percent among rural DMCs. About 22.0 percent patient was unaware about duration of treatment. Whereas important reason for dissatisfaction with service was ‘difficulty to come on alternate day’. 

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

2019 ◽  
Vol 8 (5) ◽  
pp. 981 ◽  
Author(s):  
Parigna R. Trivedi ◽  
Tejas M. Khakhkhar
Keyword(s):  
Treatment Outcome ◽  
Tertiary Care ◽  
Control Programme ◽  
High Rate ◽  
Care Hospital ◽  
Factors Affecting ◽  
Institutional Ethics ◽  
Short Course ◽  
Directly Observed Treatment

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.

scholarly journals Experiences of patients having tuberculosis (TB) regarding the use of Directly Observed Treatment Short-Course (DOTS) in the North West Province, South Africa

Curationis ◽  
2016 ◽  
Vol 39 (1) ◽  
Author(s):  
Maserapelo G. Serapelwane ◽  
Mashudu Davhana–Maselesele ◽  
Gaboipolelwe M. Masilo
Keyword(s):  
South Africa ◽  
Community Health ◽  
Health Centre ◽  
Sampling Technique ◽  
Contributory Factor ◽  
North West ◽  
Contextual Design ◽  
Short Course ◽  
North West Province ◽  
Directly Observed Treatment

Background: Tuberculosis (TB) management remains a major challenge despite the implementation of Directly Observed Treatment Short-Course (DOTS). Some of the challenges include defaulting treatment, low TB cure rates and relapse after patients had been treated under DOTS.Objectives: This study explored and described experiences of patients having TB regarding the use of DOTS in Doctor Ruth Segomotsi Mompati District of North West Province, South Africa. The study describes and recommends support required by patients having TB who are using DOTS.Methods: A qualitative, exploratory, descriptive and contextual design was used. The population consisted of all patients having TB under DOTS who had taken treatment for 2 months and more in one of the community health centres in Doctor Ruth Segomotsi Mompati District. Purposive sampling technique was applied to select participants receiving DOTS service. In-depth unstructured individual interviews were conducted, and data saturation occurred after having interviewed 15 participants. Ethical considerations were ensured throughout the study, and data were analysed using Tesch’s method of coding and analysis.Results: Two themes emerged from data and these are discussed as concerns related to ineffective use of DOTS and lack of resources as contributory factor to ineffective use of DOTS. Among other categories, poor nurse–patient relationships and difficulties in accessing the community health centre emerged as consistent themes related to default and inconsistent use of DOTS.Conclusion: Ineffective use of DOTS contributed to TB treatment default and low cure rate. Therefore, recommendations focused on strengthening effective use of DOTS for the management of TB.

scholarly journals Impact of adverse drug reaction of first line anti - tuberculous drugs on treatment outcome of tuberculosis under revised national tuberculosis control programme

2017 ◽  
Vol 4 (3) ◽  
pp. 645 ◽  
Author(s):  
Amit R. Dedun ◽  
Ghanshyam B. Borisagar ◽  
Rajesh N. Solanki
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Treatment Interruption ◽  
Control Programme ◽  
Major Health ◽  
Tuberculosis Control Programme ◽  
Short Course ◽  
Health Care Burden ◽  
National Tuberculosis ◽  
Directly Observed Treatment

Background: Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis, is the major health care burden responsible for morbidity and mortality. The objective was to study the profile of adverse drug reactions (ADRs) and its outcome.Methods: It was a prospective observational study conducted in one of the RNTCP centre of Ahmedabad district. All TB patients visiting and taking short course of directly observed treatment (DOTS) were enrolled and monitored for ADRs. All the ADRs spontaneously reported or identified by the researcher were recorded and analyzed.Results: Total 974 patients screened during the study period 72 (7.79%) developed ADRs. Significantly higher occurrence of ADRs were in age group of 31- 40 years (p<0.01). Out of these 72 patients, 49 (68%) were having pulmonary TB. No statistically significant association was found between gender of patient, site of TB and occurrence of ADRs (p>0.05). Occurrence of ADRs was significantly more (p<0.05) in patients of category I TB (31, 43%). Out of the 49 (68%) pulmonary tuberculosis patients who developed ADR, 32 patients (44%) were sputum positive showing significant association (p<0.05). Gastro-intestinal side effects were most common ADRs followed by giddiness and headache. Nine patients required complete stoppage of offending agent, while 2 patients require treatment interruption and most of the patients (61) were managed with supportive medication without removing anti tubercular drug from their treatment regimen. Out of these 72 patients, majority (56) declared cured at the end of treatment.Conclusions: ADRs are major factor limiting completion of drug therapy under RNTCP and occurrence of drug resistance which requires attention of all health care professionals.

scholarly journals Compliance with DOTS among tuberculosis patients under community based DOTS strategy in Palpa District, Nepal

2012 ◽  
Vol 1 (1) ◽  
pp. 14-19
Author(s):  
AK Nepal ◽  
K Shiyalap ◽  
S Sermsri ◽  
B Keiwkarnka
Keyword(s):  
Health Education ◽  
Compliance Rate ◽  
Treatment Compliance ◽  
Positive Association ◽  
Skills Training ◽  
Structured Interview ◽  
Community Based ◽  
Service Accessibility ◽  
Study Results ◽  
Directly Observed Treatment

INTRODUCTION: Palpa is one of the rural districts of Nepal with high incidence of tuberculosis (TB) where Community Based Directly Observed Treatment Short Course (DOTS) strategy was being trailed to make TB services accessible at community level. In spite of this, it has high defaulter rate; every year more than 5% patients had defaulted from the treatment and death due to TB was around 6%. The study, therefore, aimed to assess the patients’ compliance to the treatment and its associated factors. MATERIALS AND METHODS: A quantitative crosssectional study was carried out using structured interview schedule. All registered TB patients (n=101) who were on treatment were enrolled in the study. RESULTS: TB patients of younger age group were found to be more compliant to the treatment (p=0.02). Side effect of the drugs was the major reason for the non compliance (36.00%). More than half of the TB patients had poor knowledge on TB and its treatment. Compliance was found to be significantly associated with knowledge (p=0.02) and perception (p=0.02) of the patients towards TB. Similarly, the study showed positive association between the compliance and service accessibility (distance: p=0.00), availability of treatment supervisor (p=0.01) and health education (p=0.02). CONCLUSIONS: Patients’ compliance with the TB treatment was found to be associated with their knowledge and perception on TB and its treatment. Health education and proper counseling was deemed necessary for the patients. Service accessibility along with communication skills training to the providers including community health volunteers can increase compliance rate. DOI: http://dx.doi.org/10.3126/ijim.v1i1.6717Int J Infect Microbiol 2012;1(1):14-19

scholarly journals Study of socio-demographic and treatment profile and other epidemiological correlates of clients attending revised national tuberculosis control programme clinic in a tertiary hospital of West Bengal, India

2020 ◽  
Vol 7 (2) ◽  
pp. 742
Author(s):  
Subha Sankha Kundu ◽  
Rajib Sikder ◽  
Rituraj Dey ◽  
Kunal Kanti Majumdar ◽  
Gautam Joardar
Keyword(s):  
Tertiary Hospital ◽  
Control Programme ◽  
Sputum Smear ◽  
Medical College ◽  
Tuberculosis Control Programme ◽  
Short Course ◽  
The World ◽  
National Tuberculosis ◽  
Directly Observed Treatment ◽  
Treatment Profile

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria spread by droplet infection.According to global TB report 2017, there were approximately 28 lakhs cases of TB in India accounting a quarter of the world TB cases. Today, it is the fastest-expanding and the largest program in the world in terms of patients initiated on treatment and the second largest in terms of population coverage. The objective of this study is to assess the socio-demographic profile of the patients attending revised national TB control programme (RNTCP) clinic, to determine the nature of disease, its co-morbidities, seasonal variability and treatment profile of the patients attending the RNTCP clinic during this study period.Methods: This was a retrospective record-based study conducted in RNTCP clinic of KPC Medical College and Hospital, Kolkata. Details of all the 684 patients who were enrolled under RNTCP from the year 2014 to 2018 were collected from RNTCP records. Data was analyzed using suitable software.Results: 684 cases were registered and treated under directly observed treatment, short-course (DOTS) during the study period with 41% completing treatment. 84.3% were new TB cases. 23.61% were sputum smear positive. Males (67.25%) contributed to more in cases. Maximum patients visited during March to June. 74.87% of the total patients were diagnosed with pulmonary TB. Pleural effusion was the commonest form of extrapulmonary TB (42.75%).Conclusions: The number of TB cases showed a decreasing trend over the years. Males contributed to a greater number of cases with majority being contributed by the age group 21-30 years.

scholarly journals Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study

2021 ◽  
Vol 9 ◽  
pp. 205031212198949
Author(s):  
Cylia Nkechi Iweama ◽  
Olaoluwa Samson Agbaje ◽  
Prince Christian Ifeanachor Umoke ◽  
Chima Charles Igbokwe ◽  
Eyuche Lawretta Ozoemena ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Cross Sectional Study ◽  
Medication Nonadherence ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
North West ◽  
Short Course ◽  
Directly Observed Treatment

Introduction: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. Methods: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05) Results: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence. Conclusion: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.

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