RESUMO
To recognize the factors behind premature stoppage of anti-tuberculous drugs in drug defaulters. Cases of pulmonary tuberculosis who discontinued anti-tuberculous drugs for atleast on month, developed tuberculosis again and anti-tuberculous drugs had to be resumed were labelled as drug defaulters and studied in details. In-patients of Tuberculosis Hospital, Khulna [A Divisional Tuberculosis Hospital], Bangladesh. One hundred and seventy nine cases of drug defaulters who discontinued anti-tuberculous drugs earlier were studied during the period January 1996 to June 1998. Clinical characteristics, anti-tuberculous and associated drugs prescribed and reasons behind premature stoppage of drugs in drug defaulters. The age of 179 [males 119 and females 60] cases ranged from 11-65 years with a mean +/- SDof 35.8 +/- 12.7 years. 30.3% of the male cases were farmers. 167 [93.3%] cases initially started a good short course regimen, but discontinued later on. 110 [61.5%] cases discontinued after one month and further 42 [23.5%] cases within another one month. Maximum 72 [40.2%] number of cases discontinued therapy due to financial constraints. Other reasons for defaulting were, poor briefing in 41 [22.9%], ignorance 31 [17.3%], adverse effects of drugs 18 [10.1%], apparent subjective improvement 11 [6.1%] and scarcity of drugs in 6 [3.4%]. Since drug defaulters may play a vital role in the emergence of multi-drug resistant tuberculosis, the reasons behind premature discontinuation of drugs need to be identified and appropriately dealt with. Since cost is the major factor, anti-tuberculous drugs should be made available free of cost under direct supervision, if possible and the cases should also be reviewed periodically