An assessment of treatment compliance among patients on DOTS under revised national tuberculosis control programme in district Rewa, Madhya Pradesh, India.

Background: India is the highest TB burden country in the world. In the year 2006, annual performance of revised national tuberculosis control programme (RNTCP) in India, in terms of cure rate of new smear positive patients was 84%, default rate was 6.4% while in Madhya Pradesh it was 82% and 7.6% respectively. Rewa district have poor performance as compare to national level. Non-adherence with treatment has been recognized as an important factor responsible for low cure rate and high incidence of drug resistant TB. The objective of study was to find out the compliance rate with DOTS and associated factors responsible for non-compliance in the district. Methods: The present observational study was carried out at fifteen selected DMC cum DOTS centers of Rewa district, M.P. Results: Of the 337 patients interviewed, majority of patients 270 (80.11%) complied and 67 (19.88%) did not comply to treatment. The main reasons for non-compliance were false perception of having their disease cured because they felt well with initial treatment 26 (38.81%), side effects of drugs 23 (34.33%), anxiety of loss of wages 9 (13.43%) and Migration of patients 7 (10.44%). Conclusions: Repeated counselling and motivation of noncompliant patients would be helpful to reduce noncompliance to treatment.

Non A non B hepatitis epidemic in Rewa district of Madhya Pradesh.

An epidemic of viral hepatitis occurred at Rewa district of Madhya Pradesh during December 1989 through April 1990. A total of 302 cases were admitted to Gandhi Memorial Hospital. Few cases were reported from the adjacent rural areas. Twenty six of the 40 wards of the city were affected and 7 wards were most affected with attack rates ranging from 3-7 per cent. Seventy one per cent of the hospitalised cases were 15 to 35 years of age. Males constituted 72.2% of the cases. In 37 patients (12.2%) the illness had a fatal outcome. The cases fatality rate was 7.9% in males and 20.6% in females. There were leakages in water supply pipe lines at many places which ran parallel to or were laid across open gutters. The source of infection appeared to be water contaminated by sewage. Results of serological tests indicated a non-A, non-B hepatitis viral aetiology of the epidemic.