Risk Factors for Treatment Default among Re-Treatment Tuberculosis Patients in India, 2006

Ugra Mohan Jha, Srinath Satyanarayana, Puneet K Dewan, Sarabjit Chadha, Fraser Wares, Suvanand Sahu, Devesh Gupta and L S Chauhan

PLOS ONE, 2010, vol. 5, issue 1, 1-7

Abstract: Setting: Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment. Objective: To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients. Methodology: For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters. Results: 1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%–75% interquartile range 44–117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2–1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1–1.6], have previous treatment from non-RNTCP providers (AOR 1.3, 95%CI 1.0–1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1–1.6). Conclusions: Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pre-treatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening.

Date: 2010
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0008873

DOI: 10.1371/journal.pone.0008873

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