Does provision of cash incentive to HIV-infected tuberculosis patients improve the treatment success in programme settings? A cohort study from South India

Amuje Rohit; Ajay M. V. Kumar; Pruthu Thekkur; Suresh G Shastri; Ravi B. N. Kumar; Abhay S Nirgude; Mahendra M Reddy; Chinnappareddy Ravichandra; Narasimhaiah Somashekar; PS Balu

doi:10.4103/jfmpc.jfmpc_474_20

Users Online: 4516

ORIGINAL ARTICLE

Year : 2020 | Volume : 9 | Issue : 8 | Page : 3955-3964

Does provision of cash incentive to HIV-infected tuberculosis patients improve the treatment success in programme settings? A cohort study from South India

Amuje Rohit¹, Ajay M. V. Kumar², Pruthu Thekkur³, Suresh G Shastri⁴, Ravi B. N. Kumar⁵, Abhay S Nirgude⁶, Mahendra M Reddy⁷, Chinnappareddy Ravichandra⁸, Narasimhaiah Somashekar⁸, PS Balu¹
¹ Department of Community Medicine, JJM Medical College, Davanagere, Karnataka, India
² Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; Centre for Operational Research, The Union South-East Asia Office, New Delhi; Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed To Be University), Mangaluru, Karnataka, India
³ Centre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; Centre for Operational Research, The Union South-East Asia Office, New Delhi, India
⁴ Department of Health and Family Welfare Services, State Tuberculosis Cell, Bangalore, Karnataka, India
⁵ Department of Health and Family Welfare Services, National AIDS Control Organization (NACO), New Delhi; Department of Health and Family Welfare Services, Karnataka State AIDS Prevention Society (KSAPS), Bangalore, Karnataka, India
⁶ Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed To Be University), Mangaluru, Karnataka, India
⁷ Department of Community Medicine, Sri Devaraj Urs Medical College (SDUMC), Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Tamaka, Kolar, Karnataka, India
⁸ National Tuberculosis Institute, Bangalore, India

Correspondence Address:
Dr. Amuje Rohit
Department of Community Medicine, JJM Medical College, Davanagere, Karnataka - 577004
India

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/jfmpc.jfmpc_474_20

Background: In April 2018, the Government of India launched 'Nikshay Poshan Yojana' (NPY), a cash assistance scheme (500 Indian rupees [~8 USD] per month) intended to provide nutritional support and improve treatment outcomes among tuberculosis (TB) patients. Objective: To compare the treatment outcomes of HIV-infected TB patients initiated on first-line anti-TB treatment in five selected districts of Karnataka, India before (April–September 2017) and after (April–September 2018) implementation of NPY. Methods: This was a cohort study using secondary data routinely collected by the national TB and HIV programmes. Results: A total of 630 patients were initiated on ATT before NPY and 591 patients after NPY implementation. Of the latter, 464 (78.5%, 95% CI: 75.0%–81.8%) received at least one installment of cash incentive. Among those received, the median (inter-quartile range) duration between treatment initiation and receipt of first installment was 74 days (41–165) and only 16% received within the first month of treatment. In 117 (25.2%) patients, the first installment was received after declaration of their treatment outcome. Treatment success (cured and treatment completed) in 'before NPY' cohort was 69.2% (95% CI: 65.6%–72.8%), while it was 65.0% (95% CI: 61.2%–68.8%) in 'after NPY' cohort. On adjusted analysis using modified Poisson regression we did not find a statistically significant association between NPY and unsuccessful treatment outcomes (adjusted relative risk-1.1, 95% CI: 0.9–1.3). Conclusion: Contrary to our hypothesis and previous evidence from systematic reviews, we did not find an association between NPY and improved treatment outcomes.

[FULL TEXT] [PDF]*

Table of Contents

Similar in PUBMED

Search Pubmed for

Search in Google Scholar for

Related articles

Citation Manager

Access Statistics

Reader Comments

Email Alert *

Add to My List *

* Requires registration (Free)

Article Access Statistics

Viewed	976

Printed	8

Emailed	0

PDF Downloaded	126

Comments	[Add]