A Study on Patient Compliance of Tuberculosis Enrolled Under Revised National Tuberculosis Control Programme

Authors

  • Salil Sakalle MGM Medical College, Indore, MP
  • Bhagwan Waskel MGM Medical College, Indore, MP
  • Sanjay Dixit MGM Medical College, Indore, MP
  • Dhruvendra Pandey MGM Medical College, Indore, MP
  • Suraj Sirohi MGM Medical College, Indore, MP
  • Satish Saroshe MGM Medical College, Indore, MP

Keywords:

Tuberculosis, Noncompliance, Directly observed treatment short course, Defaulter, Adherence

Abstract

Background: Tuberculosis (TB) is a global health concern, India ranks first among the world’s high-burden tuberculosis (TB) countries. Noncompliance to self administered multi drug tuberculosis treatment regimens is common and is the most important cause of failure of initial therapy and relapse.

Objective: To assess various aspects of patient compliance to DOTS for the treatment of tuberculosis, to assess the role of socio-demographic factors, life style related factors, side effects of anti tubercular drugs in patient compliance.

Material & Method: A cross sectional Study with informed written consent was conducted in 50 Sputum positive tuberculosis patients enrolled under RNTCP in Manoramaraje TB hospital (Attached to medical college & hospital) and Prakash chandsethi Hospital (UHTC) Indore. Patients were selected using convenient sampling method. All sputum positive Failure, relapse and defaulters were included in study. A predesigned, semi structured questionnaire was used as tool to interview the patients. The data was analyzed using Microsoft office excel sheet.

Results: In total 50 patients, 42% females and 58% males were included in our study. 22% and 12% of patients had history of Infection at family and workplace respectively. 44 % of total patients did not complete the category I treatment. 28% of the patients were not compliant to current treatment of Category II. Most common reason behind non compliance was obtaining relief from symptom of tuberculosis.

Conclusion: The disease mainly affects the low socioeconomic strata where maintenance of high level of compliance is difficult. The main reasons of low patient compliance are lack of awareness about the disease, more concern about earning the wages, low motivation during drug therapy and early appearance of side effects.

References

Dye C, et al: Global burden of tuberculosis: estimated incidence, prevalence and mortality by country. J Am Med Assoc 1999, 282(7):677–686.

Ahlburg D: The economic impacts of tuberculosis. Geneva: World Health Organization; 2000.

World Health Organization Global tuberculosis control: epidemiology, strategy, financing: WHO report 2009 Publication WHO/HTM/TB/ 2009.411. Geneva: World Health Organization.

Corbett EL, Bandason T, Cheung YB, Munyati S, Godfrey-Faussett P, Hayes R, et al: Epidemiology of tuberculosis in a high HIV prevalence population provided with enhanced diagnosis of symptomatic disease. PLoS Med 2007, 4(1):e22.

Dye C, Watt CJ, Bleed DM, Hosseini SM, Raviglione MC: Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. JAMA 2005, 293(22):2767–2775.

World Health Organization: Adherence to Long Term Therapies: Evidence for Action. Geneva: World Health Organization 2003 [http://whqlibdoc.who.int/publications/2003/9241545992.pdf].

Pandit N, Chaudhary SK. A study of treatment compliance in directly observed therapy for tuberculosis. Ind J Community Medicine. 2006;31:241.

World Health Organization: Treatment of tuberculosis: guidelines for national programmes. 3rd edition. Geneva; 2003.

Larsen DE, Rootman R: Physician’s role performance and patient satisfaction. SocSci Med 1976, 10:29–32.

Kincey JA, Bradshaw PW, Ley P: Patient satisfaction and reported acceptance of advice in general practice. JR Coll Gen pract 1975, 25:558–566.

Barker R: Development of a questionnaire to assess patient satisfaction with consultants in general practice. Brit J Gen Pract 1990, 40:487–490.

Health care Commission-North West London Hospitals NHS Trust: Outpatient survey report. 2004/2005.

Shargie EB: Lindtjorn B DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: A retrospective trend analysis. BMC Publ Health 2005, 5:62

Shargie EB, Lindtjørn B: Determinants of treatment adherence among smear positive pulmonary tuberculosis patients in Southern Ethiopia. PLoS Med 2007, 4:e37.

Demissie M, Kebede D: Defaulting from tuberculosis treatment at the Addis Abeba Tuberculosis Centre and factors associated with it. Ethiop Med J 1994, 32:97-106.

Getahun H, Aragaw D: Tuberculosis in rural northwest Ethiopia: community perspective. Ethiop Med J 2001, 39:283-291.

Tekle B, Mariam DH, Ali A: Defaulting from DOTS and its determinants in three districts of Arsi Zone in Ethiopia. Int J Tuberc Lung Dis 2002, 6:573-579.

Shargie EB, Lindtjørn B: Determinants of treatment adherence among smear positive pulmonary tuberculosis patients in Southern Ethiopia. PLoS Med 2007, 4:e37.

Michael KW, Belachew T, Jira C: Tuberculosis defaulters from the “dots” regimen in Jimma zone, southwest Ethiopia. Ethiop Med J 2004, 42:247-253.

Getahun H, Maher D: Contribution of “TB clubs” to tuberculosis control in a rural district in Ethiopia. Int J Tuberc Lung Dis 2000, 4:174-178.

Demissie M, Getahun H, Lindtjorn B: Community tuberculosis care through “TB clubs” in rural north Ethiopia. SocSci Med 2003, 56:2009-2018.

Sagbakken M, Frich JC, Bjune G: Barriers and enablers in the management of tuberculosis treatment in Addis-Ababa, Ethiopia: a qualitative study. BMC Public Health 2008, 8:11.

Finlay, A., Lancaster, J., Holtz, T.H., Weyer, K., Miranda, A. & van der Walt, M. 2012. Patient and provider-level risk factors associated with default from TB treatment, South Africa, 2002: A case-control study. BioMed Central 12(56).[Online]. Available: [http://www.biomedcentral.com/1471-2458/12/56/]. 1 September 2013.

Sardar, P., Jha, A., Roy, D. Roy, S. Guha, P. &Bandyoppadhyay, D. 2010. Intensive phase non-compliance to anti-tubercular treatment in patients with HIV-TB co-infection: a hospital-based cross-sectional study. Journal of Community Health 35(5):471-478.[Online]. Available: http://www.ncbi.nlm.nih.gov/pubmed/20041282]. 20 September 2013.

Bansal AK, Chandorkar RK. Immunization Status of Tribal and Non Tribal children of Raipur district, Madhya Pradesh. Tribal Health Bulletin(ICMR);1997:3(2):12-14.

Pandit N, Chaudhary SK. A study of treatment compliance in directly observed therapy for tuberculosis. Ind J Community Medicine. 2006;31:241.

Sinha T, Tiwari S. DOTS Compliance by Tuberculosis Patients in District Raipur (Chhattisgarh) Online Journal of Health and Allied Sciences ISSN 0972-5997 Volume 9, Issue 3; Jul-Sep 2010

Mehrotra ML, Gautam KD, Chaube CK. Shortest possible acceptable, effective ambulatory chemotherapy in pulmonary tuberculosis. Am Rev Respir Dis. 1981;124:239-44.

Santha T et al. Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur district, South India, 2000. The International J of Tuberculosis and Lung disease. 2002;6(9):780-788.

Bhat S, Mukherjee M et al. Unsupervised intermittent short course chemotherapy with intensive health education.Ind J of Tub. 1998;45:146:207.

ChaniKudakwashe et al Factors affecting compliance to tuberculosis treatment in andarakavango region Namibia (Available at http://uir.unisa.ac.za/bitstream/handle/10500/4778/dissertation_chani_k.pdf?sequence=1) Access on 10 September 2013

Juvekar SK et al. Social and operational determinants of patient behaviour in lung tuberculosis. Ind J of Tub. 1995;42:87-94.

Mohan Rani S et al. Feasibility of community DOTS providers for tuberculosis. Ind J of Tub. 2000;47:159.

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Published

2014-03-31

How to Cite

1.
Sakalle S, Waskel B, Dixit S, Pandey D, Sirohi S, Saroshe S. A Study on Patient Compliance of Tuberculosis Enrolled Under Revised National Tuberculosis Control Programme. Natl J Community Med [Internet]. 2014 Mar. 31 [cited 2024 Nov. 3];5(01):96-9. Available from: https://njcmindia.com/index.php/file/article/view/1327

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Original Research Articles