Indicators to Ensure Treatment Initiation of All Diagnosed Sputum Positive Pulmonary Tuberculosis Patients under Tuberculosis Control Programme in India.

BACKGROUND: Pretreatment loss to follow-up (PTLFU) is used as performance indicator of Revised National Tuberculosis Control Programme (RNTCP) of India. OBJECTIVE: To document the PTLFU, identify additional indicators and examine documentation of all the diagnosed sputum positive pulmonary tuberculosis (PTB) patients under RNTCP. METHODOLOGY: Tuberculosis (TB) laboratory, referral for treatment registers, and referral forms were perused for information on sputum positive PTB patients diagnosed from January to June 2014, in 3 TB Units in Chennai. RESULTS: PTLFU was 24% (572 out of 2361). However, in pursuance with the principle of ensuring that all diagnosed patients must be started on treatment following referral, it was inflated to 44% (1046 out of 2361). CONCLUSION: The existing PTLFU indicator does not reflect the proportion of treatment initiation of all diagnosed smear-positive PTB patients. We propose additional indicators for monitoring referral and treatment initiation of all diagnosed sputum positive PTB patients.

Sputum Conversion and Treatment Success among Tuberculosis Patients with Diabetes Treated under the Tuberculosis Control Programme in an Urban Setting in South India.

BACKGROUND: Studies from India on sputum conversion and tuberculosis (TB) treatment outcomes among TB patients with diabetes are limited. OBJECTIVE: The objective of this study is to estimate the proportion of sputum smear conversion and successful treatment outcomes among diabetic-TB patients treated under Revised National TB Control Programme (RNTCP). METHODOLOGY: Information on TB disease, diabetes, sputum conversion, and treatment outcomes were collected from treatment cards of adult TB patients (age >18 years) treated in the District TB Centre TB Unit, Tiruchirapalli, Tamil Nadu from July 1, 2014, to October 31, 2015. RESULTS: Diabetes was documented in 163 (14%) of 1131 TB patients. Sputum conversion was in 107 (94%) of 114 smear positive-TB patients. Successful TB treatment outcome was in 116 (85%) of 136 patients and 107 (86%) of 124 new TB patients. CONCLUSION: Sputum conversion was as per RNTCP target while treatment success rate among the new TB patients with diabetes was suboptimal.