A comparative evaluation of factors and reasons for defaulting in tuberculosis treatment in the states of west bengal,jharkhand and arunachal pradesh

摘要

Summary:A comparative evaluation was undertaken to determine the influence of organizational set-up and other factors on the defaulting behaviour of tuberculosis patients, The defaulting pattern was analysed in four centres., one of which was a private hospital (TMH, Jamshedpur), one an NGO (ADMH, Jamshedpur in Jharkhand) and the other two were government institutions (DTC, Purulia, West Bengal and TB Centre. Roing, Arunaehal Pradesh),In all, 1258 patients on short course chemotherapy were enrolled. Defaulters were identified by record review and interviewed either at home or in the clinic,Defaulter rate was least in TMH followed by ADMH and DTC, Purulia in that order and maximum in TB Centre, Roing. Age distribution of the defaulters was similar in ADMH and DTC, the percentage significantly increasing with age. the maximum being in 45-59 years and declining thereafter. In TMH and TB Centre, the percentage of defaulters continued to remain high even in the older age groups. The percentage of defaulters decreased uniformly with increasing income in the DTC and TB Centre with a peak in the middle income group in ADMH and all high income group defaulters in TMH. For all. the proportion of defaulters decreased uniformly with increasing educational status The time of defaulting was similar in all institutions, starting at the third month, increasing upto the fourth month and declining subsequently. Among the various reasons for defaulting, the important ones were distance from treatment centre, indifference due to improvement in symptoms and lack of motivation.