A study to assess the association of various factors of adherence to treatment on the tuberculosis treatment outcome among new sputum smear positive pulmonary tuberculosis patients under Revised National Tuberculosis Control Programme in Bengaluru area

ABSTRACT

Background: Tuberculosis (TB) is a top infectious disease killer worldwide. In India although Revised National Tuberculosis Control Programme (RNTCP) has seen significant success in TB treatment, patient non-adherence or lost to follow up continue to persist and are influenced by various factors. The present study aims to know the influence of adherence factors on TB treatment outcome among new sputum smear positive (NSSP) pulmonary TB patients under RNTCP. The objectives of the present study were to describe the distribution of socio-demographic factors, outcome patterns among NSSP patients and to assess the association of various adherence factors on TB-treatment outcome among NSSP patients.Methods: A prospective longitudinal study among 149 NSSP patients from selected TU’s of Bengaluru.Results: Among the 149 NSSP patients 107 (72%) were males and 42 (28%) were females. Treatment outcome is categorized as cured (120) and other treatment outcomes (defaulted-17 or treatment failure-3 or died-9). Among the various socio-demographic and adherence-factors age >50years, illiteracy, male-gender, Hindu-religion, lower socioeconomic-status, poor-patient knowledge about TB, disbelief in TB-treatment, unwillingness to continue treatment with subsiding symptoms, smoking, alcohol intake, presence of diabetes or hypertension or COPD or HIV, patient’s un-satisfaction with treatment-availability or accessibility or contact-timings, no-encouragement from family members, other marital status and absence of stigma showed lower cure rates. Of these factors illiteracy, lower socioeconomic-status, poor patient’s knowledge on tuberculosis, smoking, alcohol intake, HIV positive status, un-satisfaction with TB-treatment availability and other marital-status showed statistical significance on the TB treatment outcome.Conclusions: With the observed associations of the above factors on TB-treatment outcome, Further measures like improving patient’s knowledge on tuberculosis, health-services and patient-provider relationship; appropriate TB-HIV care and encouragement to quit smoking or alcohol intake, could improve TB-treatment cure rates.