A study to identify the factors responsible for the delay in treatment initiation of MDR–TB Cases registered under RNTCP in a district of south India.

Madala P; Jonnalagadda RK; Sastry TVSN; Samyukta R; N Hanumanth; Raju CN

Volume : V, Issue : IX, September - 2016

A study to identify the factors responsible for the delay in treatment initiation of MDR–TB Cases registered under RNTCP in a district of south India.

Madala P, Jonnalagadda Rk, Sastry Tvsn, Samyukta R, N Hanumanth, Raju Cn

Abstract :

Background: The economic burden to manage Multi–drug resistant Tuberculosis (MDR–TB) cases is very high as the average cost of drugs alone for treating MDR–TB patient is 50 to 200 times higher than for treating a drug–susceptible TB patient. If left undiagnosed or poorly treated, MDR–TB patients often live and suffer for years before succumbing to the disease and hence transmission of multi–drug resistance strains can continue, amplifying the multi–drug resistance in the community. Timely identification of MDR–TB cases and prompt initiation of treatment is crucial to prevent the transmission of disease and reduce the associated high morbidity and mortality. Hence, this study was conducted to find out the factors for the delay in treatment initiation of MDR–TB Cases. Methodology: The present study was a Community based Cross–sectional study conducted among the MDR–TB Patients registered under RNTCP in all the 9 Tuberculosis Units (TUs) of Krishna District, Andhra Pradesh from November 2012 to October 2014. The total number of study participants that were interviewed were 97 after applying inclusion and exclusion criteria .The perceptions of the MDR–TB patients and the Key staff of District TB Office, Krishna District have also been obtained regarding treatment delay. Results: Males were 68% of the total subjects and most (68%) of them belong to �rural� background. Most (85%) of the study subjects belong to the lower Socio–Economic Status (SES) and a majority (81%) belong to the �Hindu Religion�. About 35% of MDR–TB patients belong to �Unskilled� occupation group while 31% belong to �Unemployed� occupation group. Majority of the study subjects were �married� (88%) and the educational status was below primary level in 71% of them. Conclusion: The factors that were found statistically significant for treatment delay were presence of co–morbid illness, alcohol consumption, lack of family support, long distance of Drug Resistant TB centre (DR–TB) centre from patient�s residence and Lower Socio–Economic Status (SES)