Evaluation of DOTS tuberculosis control program, Wardha District, India.

摘要

Background. Revised National Tuberculosis Control Program (RNTCP) using DOTS strategy in Wardha District, India, has accomplished the targets of achieving and maintaining at least 85% cure rate of new sputum smear-positive patients and to achieve and maintain detection of at least 70% of these cases in the population. The targets have stagnated for the past three years, prompting a need for program evaluation to achieve over 95% case detection and treatment success rates.;Methods. A process evaluation study involving mixed method approach of quantitative and qualitative analysis was planned. A logic model was built and stakeholder analysis conducted after establishing the timeline. Statistical analysis was done to interpret the treatment outcomes in DOTS Tuberculosis Control Program.;Results. Processes that significantly impact the treatment outcomes were identified. Weight record of DOTS cases, sputum smear microscopy before moving into the continuation phase of treatment and excess duration to complete treatment, was highly significant. Gaps in pediatric and female case detection were identified.;Conclusions. It is possible to achieve and maintain over 95% case detection and treatment success. Coordination of supervisory activities is necessary in Wardha district, India. The results are generalizable to other DOTS districts in India, with due caution.