1Senior Resident, Department of Medicine, Gandhi Medical College, Bhopal
2Assistant Professor, Department of Community Medicine, Peoples College of Medical Sciences, Bhopal
3Assistant Professor, Department of Community Medicine, L.N. Medical College, Bhopal
4Dean, Bundelkhand Medical College, Sagar, MP
5Associate Professor, Department of Community Medicine, Gandhi Medical College, Bhopal
6Assistant Professor-Biostatistics, Department of Community Medicine, Peoples College of Medical Sciences, Bhopal
*Corresponding author: Sameer Phadnis, Asst. Professor, Dept. of Community Medicine, Peoples College of Medical Sciences, Bhopal-462037, Fax No. 0755-4005112, Tel-0755-4005118, Mobile: 09977555696, E-mail-sameerphadnis_78@rediffmail.com
Online published on 23 January, 2014.
The directly observed treatment strategy (DOTS) under the revised national tuberculosis control programme(R.N.T.C.P) of India shifts the ultimate responsibility for patient cure from the patient to health system, there remain considerable challenges for organizations in achieving adherence to long term regimens for tuberculosis treatment. These challenges centre on structural, disease related, social and personal issues.
To investigate how socio-demographic profile, disease status, and knowledge, attitude and motivation related issues were associated with non- adherence to anti-tubercular treatment in patients registered under revised national tuberculosis control programme in an urban setting in India
This was a Matched paired case control study conducted in 20 Directly Observed Treatment/microscopy centers under R.N.T.C.P located in urban area of Bhopal district, India from November 2006 to October 2007. A simple random sample (n=193) of documented ‘defaulters’ (not taken anti tubercular drugs 2 months or more consecutively after starting treatment) was drawn from tuberculosis register. Suitable age and sex matched non -defaulter subjects were taken as controls from the same tuberculosis register. A pre-tested semi-structured questionnaire was administered to study subjects for data collection
Factors associated with non adherence to anti-tuberculosis treatment were alcohol abuse, frequent change of residence, homelessness, lack of awareness about exact duration of treatment and consequences of terminating treatment before stipulated time; and perceived uncertainty about treatment success. Illiteracy, unemployment, status of family cohesion, smoking, and hiding disease from the family were the variables that didn't show statistically significant association with nonadherence to treatment
Individual characteristics, at-risk behaviors as well as structural issues, such as homelessness. determine non-adherence to anti-tubercular treatment under RNTCP.The program should take account of patient's convenience and preferences.
Tuberculosis, DOTS, Default, Non-Adherence, Behavioral, Non-Programmatic
