A study of compliance to DOTS among tuberculosis patients attending a district hospital, Uttar Pradesh
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20192845Keywords:
DOTS, Compliance, Tuberculosis, Noncompliance, DefaultAbstract
Background: Tuberculosis is an old disease and has deep social impact on the society. It is a re-emergent killer disease with rise in MDR and XDR strains. DOTS strategy under RNTCP has had a substantial impact over the past two decades. Treatment compliance is one of the key factors determining success of TB control program. The objective of this study was to find out the compliance rate with DOTS and factors responsible for non-compliance in the district.
Methods: A cross-sectional study was carried out using structured questionnaire in a tuberculosis unit of Chandauli district, Uttar Pradesh. 100 tuberculosis patients aged ≥15 years registered for TB treatment were enrolled in the study.
Results: Out of the 100 patients interviewed, majority of patients (95%) complied. The main reasons for non-compliance were improvement in symptoms after initial doses leading to discontinuation of therapy, and side effects of drugs. One of the defaulter migrated, so he could not be traced. Among factors influencing compliance to DOTS most important was strong monitoring.
Conclusions: Health education and easy accessibility of healthcare services are required to further improve the compliance of TB treatment. Internet tools and social security schemes can play essential role in increasing awareness and strengthening the monitoring program.
References
World Health Organization. Global tuberculosis report 2018. Available at: https://www.who.int/tb/ publications/global_report/en/. Accessed on 2 January 2019.
World Health Organization. Tuberculosis, Fact Sheet. Available at: https://www.who.int/en/news-room/fact-sheets/detail/tuberculosis. Accessed on 2 January 2019.
Terra MF, Bertolozzi MR. Does directly observed treatment (“DOTS”) contribute to tuberculosis treatment compliance? Rev Latino-am Enfermagem. 2008;16(4):659-64.
World Health Organization. What is DOTS? A guide to understanding the WHO-recommended TB control strategy known as DOTS. Available at: https://www.who.int/tb/publications/dots-who-guide/en/. Accessed on 2 January 2019.
India TB. Revised National Tuberculosis Control Programme. Central TB Division, Directorate General of Health Services, Ministry of Health & Family Welfare, Nirman Bhavan, New Delhi; 2008.
DOTS-Plus Guidelines. Revised National Tuberculosis Control Programme. Annual status report. Central TB Division, Directorate General of Health Services, Ministry of Health & Family Welfare, Nirman Bhavan, New Delhi.
Mittal C, Gupta SC; Noncompliance to DOTS: How it can be decreased. Indian J Community Med. 2011;36(1):27–30.
Kumar N, Gupta N, Kishore J. Kuppuswamy's socioeconomic scale: updating income ranges for the year 2012. Indian J Public Health. 2012;56(1):103-4.
RNTCP at a GLANCE. Central TB division, Directorate General of Health Services, Ministry of Health and Family Welfare. Volume 25. New Delhi: Nirman Bhavan; 2005.
Bhadke BB, Rathod R, Deshmukh DG, Luniya A. Study of various causes of defaulter among tuberculosis patients under revised national tuberculosis control programme: a prospective analysis of 5235 tuberculosis patients. Int J Res Med Sci. 2016;4:2619-22.
Jain M, Swarnkar M, Mehta SC, Kumar V. Evaluation study of treatment outcome in Tuberculosis patients receiving DOTS under RNTCP. Indian J Comm Health. 2016;28(4):352-8.
Rai N, Kushwah SS, Singh SP, Dubey D. An assessment of treatment compliance among patients on DOTS under revised national tuberculosis control programme in district Rewa, Madhya Pradesh, India. Int J Community Med Public Health. 2015;2(4):373-9.
Kumar M, Singh JV, Srivastava AK, Verma SK. Factors affecting the non-compliance in directly observed short course chemotherapy in Lucknow district. Indian J Commun Med. 2002;27(3):114-7.
Gopi PG, Vasantha M, Muniyandi M, Chandrasekharan V, Balasubramaniam R. Risk factor for Non adherence to directly observed treatment (DOTs) in a rural tuberculosis unit, South India. Indian J Tuberc. 2007;54(3):66-70.
Jaggarajamma K, Sudha G, Chandrasekaran V, Nirupa C, Thomas A, Santha T, et al. Reasons for noncompliance among patients treated under revised national tuberculosis control programme (RNTCP), Tiruvallur District, South India. Indian J Tuberc. 2007;54:130-5.
Gad A, Mandil AMA, Sherif AAR, Gad ZM, Sallam S. Compliance with antituberculosis drugs among tuberculosis patients in Alexandria, Egypt. East Medit health J. 1997;3(2):244-50.
Kaona FA, Tuba M, Siziya S, Sikaona L. An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC Public Health. 2004;4:68.
Juvekar SK, Morankar SN, Dalal DB, Rangan SG, Khanvilkar SS, Vadair AS, et al. Social and operational determinants of patient behaviour in lung tuberculosis. Indian J Tub.1995;42:87.
Jaggarajamma K, Sudha G, Chandrasekaran V, Nirupa C, Thomas A, Santha T, et al. Reasons for noncompliance among patients treated under revised national tuberculosis control programme (RNTCP), Tiruvallur District, South India. Indian J Tuberc. 2007;54:130-5.
Chattergee P, Benerjee B, Dutt D, Pati RR, Mullick A. A Comparative evaluation of factors and reasons for defaulting in tuberculosis treatment in the states of West Bengal, Jharkhand and Arunachal Pradesh. Indian J Tuberc. 2003;50:17–21.