Comparing outcomes in new pulmonary sputum positive and sputum negative cases under RNTCP in rural India.

Setting: The study was carried out at the Bagula TU, Nadia, West Bengal, India. Objective: To find out the treatment outcomes of new smear negative cases, in low HIV prevalence population, and to compare the results with new smear positive cases in the same population. Design: It was a retrospective record based study. All patients registered between January 1999 and June 2005 were divided into new smear positive and new smear negative groups and the difference in the outcomes analysed. Results: Favourable outcome was less in new smear negative cases, compared to new smear positive (84% vs. 86%, p= 0.002).Death and default were more in new smear negative cases, compared to new smear positive (death: 6.8% vs. 3.7%; default: 6.02% vs. 4.18%), (p < 0.05). Failure and transferred out were non- significantly higher in new smear positive group. Conclusions: Smear negative patients had a worse treatment outcome compared to smear positive patients including lower favourable outcomes and higher deaths and defaults. The possible reasons need to be explored and corrective actions need to be taken accordingly.