Journal of Family Medicine and Primary Care

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 Nirgude7, Mahendra M Reddy6, Chinnappareddy Ravichandra7, Narasimhaiah Somashekar7, 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, Sri Devaraj Urs Medical College (SDUMC), Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Tamaka, Kolar, Karnataka, India
7 National Tuberculosis Institute, Bangalore, India

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

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.


How to cite this article:
Rohit A, Kumar AM, Thekkur P, Shastri SG, Kumar RB, Nirgude AS, Reddy MM, Ravichandra C, Somashekar N, Balu P S. Does provision of cash incentive to HIV-infected tuberculosis patients improve the treatment success in programme settings? A cohort study from South India.J Family Med Prim Care 2020;9:3955-3964


How to cite this URL:
Rohit A, Kumar AM, Thekkur P, Shastri SG, Kumar RB, Nirgude AS, Reddy MM, Ravichandra C, Somashekar N, Balu P S. Does provision of cash incentive to HIV-infected tuberculosis patients improve the treatment success in programme settings? A cohort study from South India. J Family Med Prim Care [serial online] 2020 [cited 2021 May 14 ];9:3955-3964
Available from: https://www.jfmpc.com/article.asp?issn=2249-4863;year=2020;volume=9;issue=8;spage=3955;epage=3964;aulast=Rohit;type=0