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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 3  |  Page : 388-394

Risk factors associated with default among tuberculosis patients in Darjeeling district of West Bengal, India


1 West Bengal Health Service, Burdwan District, India
2 Department of Community Medicine, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
3 Super Speciality Wing, (Anamoy Hospital) Burdwan Medical College & Hospital, Burdwan District, India
4 West Bengal Health Service, Maldah, India
5 Department of Epidemiology, All India Institute of Hygiene and Public Health, Kolkata, India
6 Department of Community Medicine, North Bengal Medical College, Darjeeling District, West Bengal, India

Correspondence Address:
Dr. Mausumi Basu
Department of Community Medicine, IPGME and R and SSKM Hospital, Kolkata
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.161330

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Background: The treatment outcome "default" under Revised National Tuberculosis Control Program (RNTCP) is a patient who after treatment initiation has interrupted treatment consecutively for more than 2 months. Aims: To assess the timing, characteristics and distribution of the reasons for default with relation to some sociodemographic variables among new sputum-positive (NSP) tuberculosis (TB) patients in Darjeeling District, West Bengal. Settings and Design: A case-control study was conducted in three tuberculosis units (TUs) of Darjeeling from August'2011 to December'2011 among NSP TB patients enrolled for treatment in the TB register from 1 st Qtr'09 to 2 nd Qtr'10. Patients defaulted from treatment were considered as "cases" and those completed treatment as "controls" (79 cases and 79 controls). Materials and Methods: The enrolled cases and controls were interviewed by the health workers using a predesigned structured pro-forma. Statistical Analysis Used: Logistic regression analysis, odds ratios (OR), adjusted odds ratios (AOR). Results: 75% of the default occurred in the intensive phase (IP); 54.24% retrieval action was done within 1 day during IP and 75% within 1 week during continuation phase (CP); cent percent of the documented retrieval actions were undertaken by the contractual TB program staffs. Most commonly cited reasons for default were alcohol consumption (29.11%), adverse effects of drugs (25.32%), and long distance of DOT center (21.52%). In the logistic regression analysis, the factors independently associated were consumption of alcohol, inadequate knowledge about TB, inadequate patient provider interaction, instances of missed doses, adverse reactions of anti-TB drugs, Government Directly Observed Treatment (DOT) provider and smoking. Conclusions: Most defaults occurred in the intensive phase; pre-treatment counseling and initial home visit play very important role in this regard. Proper counseling by health care workers in patient provider meeting is needed.


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