Published: 2019-09-26

A study to assess the association of various factors of adherence to treatment on the tuberculosis treatment outcome among new sputum smear positive pulmonary tuberculosis patients under Revised National Tuberculosis Control Programme in Bengaluru area

Ramya M. S., Jyothi Jadhav, Ranganath T. S.


Background: Tuberculosis (TB) is a top infectious disease killer worldwide. In India although Revised National Tuberculosis Control Programme (RNTCP) has seen significant success in TB treatment, patient non-adherence or lost to follow up continue to persist and are influenced by various factors. The present study aims to know the influence of adherence factors on TB treatment outcome among new sputum smear positive (NSSP) pulmonary TB patients under RNTCP. The objectives of the present study were to describe the distribution of socio-demographic factors, outcome patterns among NSSP patients and to assess the association of various adherence factors on TB-treatment outcome among NSSP patients.

Methods: A prospective longitudinal study among 149 NSSP patients from selected TU’s of Bengaluru.

Results: Among the 149 NSSP patients 107 (72%) were males and 42 (28%) were females. Treatment outcome is categorized as cured (120) and other treatment outcomes (defaulted-17 or treatment failure-3 or died-9). Among the various socio-demographic and adherence-factors: age >50years, illiteracy, male-gender, Hindu-religion, lower socioeconomic-status, poor-patient knowledge about TB, disbelief in TB-treatment, unwillingness to continue treatment with subsiding symptoms, smoking, alcohol intake, presence of diabetes or hypertension or COPD or HIV, patient’s un-satisfaction with treatment-availability or accessibility or contact-timings, no-encouragement from family members, other marital status and absence of stigma showed lower cure rates. Of these factors illiteracy, lower socioeconomic-status, poor patient’s knowledge on tuberculosis, smoking, alcohol intake, HIV positive status, un-satisfaction with TB-treatment availability and other marital-status showed statistical significance on the TB treatment outcome.

Conclusions: With the observed associations of the above factors on TB-treatment outcome, Further measures like improving patient’s knowledge on tuberculosis, health-services and patient-provider relationship; appropriate TB-HIV care and encouragement to quit smoking or alcohol intake, could improve TB-treatment cure rates.



Pulmonary tuberculosis, Adherence factors, Treatment outcome

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Park K. Park’s textbook of preventive and social medicine. 23rd ed. Jabalpur, India: M/s Banarsidas Bhanot; 2015;176-202:427-30.

WHO. Tuberculosis fact sheets, 2016 March; Available at: eets/fs104/en/. Accessed on 9 August 2016.

The Global Plan to End TB 2016-2020, 2015. Available at: 2/. Accessed on 27 August 2016.

Gupta I, Guin P. Communicable diseases in South-East Asia region of the World Health Organisation: towards a more effective response. Bull World Health Organ. 2010;88:199-205.

RNTCP Technical and Operational Guidelines for Tuberculosis Control in India, 2016. Available at: Accessed on 4 September 2016.

Global Tuberculosis report 2015, 2015. Available at: report/gtbr2015_executive_summary.pdf. Accessed on 28 August 2016.

Central TB Division. TB INDIA 2016 Annual status report, 2016. Available at http://www.tbcindia. Accessed 8 August 2016.

WHO. Adherence to long-term therapies, 2003. Available at: 10665/42682/1/9241545992.pdf. Accessed on 27 August 2016.

Adherence to treatment for latent tuberculosis infection: a manual for health care providers, 2005. Available at: Accessed on 12 August 2016.

Gajbhare D, Bedre R, Solanki H. A study of socio-demographic profile and treatment outcome of tuberculosis patients in an urban slum of Mumbai. Indian J Basic Appl Med Res. 2014;4(1):50-7.

Sadana P, Singh T, Deepti SS. Socio demographic factors affecting the treatment outcome in patients of tuberculosis. Nat J Community Med. 2015;6(4):609-13.

Sunil MS, Rahul RB. Socio-demographic profile of patients registered under revised national tuberculosis control programme in Pune city. Int J Biomed Res. 2014;5(3):168-71.

Detels R, Gulliford M, Karim Q, Tan C. Oxford Textbook of Global Public Health. 6th ed. Great Clarendon Street, Oxford: Oxford University Press; 2016: 1144-1160.

Vijay V, Vigneswari A, Selvan K, Satyavani K, Rajeswari R, Kapur A. Effect of diabetes on treatment outcome of smear-positive pulmonary tuberculosis- a report from South India. J Diabet Complicat. 2014;28(2):162-5.

Vijay S, Kumar P, Chauhan LS, Narayan Rao SV, Vaidyanathan P. Treatment outcome and mortality at one and half year follow-up of HIV infected TB Patients Under TB Control Programme in a District of South India. PLoS ONE. 2011;6(7):e21008.