CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2020; 10(03): 116-121
DOI: 10.1055/s-0040-1716313
Original Article

Determinants of Categories of TB Retreatment with Special Reference to Sources of Primary Anti-TB Treatment

Veerabadran Karthikeyan
1   Department of Community Medicine, Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai, Tamil Nadu, India
,
Kalaiselvan Ganapathy
2   Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
› Author Affiliations
Funding The authors acknowledge the funding received from Chest clinic, Puducherry, under RNTCP financial assistance: MDPG thesis grant.

Abstract

Introduction Retreatment (previously treated) cases are the tuberculosis (TB) patients who have been treated previously with anti-TB drugs for at least a month and who have now been registered for category II anti-TB therapy. Retreatment cases arise due to inadequate and improper treatment of the new TB cases.

Objective The aim of the study is to assess the information regarding sources of previous TB drug exposure and treatment practices leading to retreatment cases (category II) and determinants leading to retreatment.

Material and Methods It was a community-based cross-sectional study of patients registered as retreatment TB cases under revised national TB control program (RNTCP) in the TB unit of Puducherry between October 2013 and September 2014. The study was held between October 2013 and October 2015. Initially the quantitative data were collected and followed by qualitative data. Data were collected by interviewing the patients using a predesigned questionnaire. Data were entered and analyzed by using Epi Info (Version 3.4.3) software package.

Results Out of the 193 study participants, relapse cases were the most common 50.8%, followed by treatment after default cases 23.8%, failure cases 11.9%, and retreatment others 13.5%. There is a significant association between the retreatment categories such as failure, TAD (treatment after default), retreatment others, and ever usage of tobacco (p < 0.05). There is also a significant association between the retreatment categories such as TAD, retreatment others, and ever usage of alcohol (p < 0.05). The sources of previous antitubercular therapy for 90.16% retreatment cases were from government health care facilities under RNTCP, whereas for 9.84% retreatment cases the sources of previous antitubercular treatment were private health care facilities. There is a significant association between public health care facility where patients were previously treated for TB and relapse (p = 0.001) and private health care facility where patients were previously treated for TB and TAD (p = 0.008).

Conclusion As 90% of the patients have utilized the government health services for treatment, it shows the effective functioning of RNTCP-STF (state task force-revised national TB control program) mechanism in Puducherry.



Publication History

Article published online:
20 August 2020

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  • References

  • 1 World Health Organization. The stop TB strategy; 2006. Available at: http://apps.who.int/iris/bitstream/10665/69241/1/WHO_HTM_STB_2006.368_eng.pdf. Accessed September 9, 2015
  • 2 World Health Organization. Tuberculosis Control in South East Asia. Annual TB report 2015; 2015. Available at: http://www.searo.who.int/tb/annual-tb-report-2015.pdf. Accessed August 13, 2015
  • 3 World Health Organization. Treatment of tuberculosis guidelines. Available at: http://www.ncbi.nlm.nih.gov/books/NBK138748/pdf/Bookshelf_NBK138748.pdf. Accessed August 11, 2015
  • 4 RNTCP at a GLANCE. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi 110001. Available at: http://www.tbcindia.nic.in/pdfs/RNTCP%20at%20a%20Glance.pdf
  • 5 World Health Organization. Stop TB partnership. Public-private mix for TB care and control: A toolkit. 2010; Available at: http://www.who.int/tb/careproviders/ppm/PPMToolkit.pdf Accessed September 9, 2015
  • 6 Operational Research Guidelines and Action Plan. Revised National Tuberculosis Control Program (RNTCP), India; 2009. Available at: http://www.tbcindia.org/pdfs/RNTCP%20 Operational% 20Research%Guidelines% 20 march%202009.pdf. Accessed January 21, 2009
  • 7 Sarpal SS, Goel NK, Kumar D, Janmeja AK. Gender disparities in retreatment patients of tuberculosis: a north Indian study. J Nat Sci Biol Med 2015; 6 (01) 63-66
  • 8 Puducherry profile. Census info India 2011. Final Population tables. Available at: http://censusindia.gov.in/2011census/censusinfodashboard/stock/profiles/en/IND034_Pondicherry.pdf. Accessed September 2, 2015
  • 9 Status of Literacy. Provisional Population Totals. Census of India 2011. Available at: http://Censusindia.Gov.In/2011-Prov-Results/Data_Files/Mp/07literacy.Pdf. Accessed September 3, 2015
  • 10 Dooley KE, Lahlou O, Ghali I. et al. Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco. BMC Public Health 2011; 11 (01) 140
  • 11 Thomas A, Gopi PG, Santha T. et al. Predictors of relapse among pulmonary tuberculosis patients treated in a DOTS programme in South India. Int J Tuberc Lung Dis 2005; 9 (05) 556-561
  • 12 Roy N, Basu M, Das S, Mandal A, Dutt D, Dasgupta S. Risk factors associated with default among tuberculosis patients in Darjeeling district of West Bengal, India. J Family Med Prim Care 2015; 4 (03) 388-394
  • 13 Vijay S, Kumar P, Chauhan LS, Vollepore BH, Kizhakkethil UP, Rao SG. Risk factors associated with default among new smear positive TB patients treated under DOTS in India. PLoS One 2010; 5 (04) e10043
  • 14 Prasad KN, Ingalgeri BM, Poovitha R. et al. Utilization of health facilities at primary health centre by rural community of Pondicherry. IAIM 2015; 2 (02) 71-76
  • 15 Niranjjan R, Sahu SK, Roy G, Vani SAV. Source of previous anti-TB treatment for re-treatment TB cases registered under Revised National Tuberculosis Control Program in Pondicherry. Int J Community Med Publ Health 2017; 4: 3386-3393
  • 16 Sachdeva KS, Satyanarayana S, Dewan PK. et al. Source of previous treatment for re-treatment TB cases registered under the National TB control Programme, India, 2010. PLoS One 2011; 6 (07) e22061
  • 17 Patel KR, Patel A, Gadhiya NB. Risk Factors for sputum positive pulmonary tuberculosis retreatment cases and factors responsible for treatment outcome. J Assoc Physicians India 2019; 67 (08) 56-58
  • 18 Varshney AM, Singh US, Kumar D. Sources of Previous anti-tubercular drug exposure for patients registered in RNTCP as Retreatment cases in District Anand, Gujarat. Indian J Community Health 2013; 25 (02) 159-163