%0 Journal Article
%T Factors Influencing Early Health Facility Contact and Low Default Rate among New Sputum Smear Positive Tuberculosis Patients, India
%A Ashok Kumar Bhardwaj
%A Surender Kashyap
%A Pradeep Bansal
%A Dinesh Kumar
%A Sunil Kumar Raina
%A Vishav Chander
%A Sushant Sharma
%J Pulmonary Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/132047
%X Early case identification and prompt treatment of new sputum smear positive case are important to reduce the spread of tuberculosis (TB). Present study was planned to study the associated factors for duration to contact the health facility since appearance of symptoms and treatment default. Methodology. It was prospective cohort study of TB patients already registered for treatment in randomly selected TB units (TUs) in Himachal Pradesh, India. Relative risk (RR) was calculated as risk estimate to find out the explanatory variables for early contact and default. Results. Total 1607 patients were recruited and 25 (1.5%) defaulted treatment. Patients from nuclear family (aRR: 1.37; 1.09每1.73), ashamed of TB (aRR: 1.32; 1.03每1.70), wishing to disclose disease status (aRR: 1.79; 1.43每2.24), but aware of curable nature (aRR: 1.67; 1.17每2.39) and preventable (aRR: 1.35; 1.07每1.70) nature of disease, contacted health facility early since appearance of symptoms. Conclusion. Better awareness and less misconceptions about disease influences the early contact of health facility and low default rate in North India. 1. Introduction One-third of the world population is infected with Mycobacterium tuberculosis causing disease in about 10 million individuals and resulting in 1.3 million deaths per year. Asia and Africa regions together share 85.0% of the global disease burden [1]. India notified total 1.3 million cases including 0.62 million sputum smear positive cases [2]. Evidence from India showed that tuberculosis (TB) contributes about 30% of deaths due to communicable disease and 7% of total deaths [2]. Based upon World Health Organization (WHO) recommendations, the Government of India implemented Directly Observed Treatment Short Course (DOTS) strategy under Revised National Tuberculosis Program (RNTCP) [2]. Since then, treatment success rate among sputum smear positive patients improved from 25% in the year 1985 to about 90% by the year 2011 [2] as compared to the global treatment success rate of 84% [1]. Early case detection and treatment is a public health principle for disease control. Under RNTCP, an awareness campaign for signs and symptoms of TB demands an early contact of health facility for diagnosis. Contact of patient to health facility for treatment compliance depended on the program and patient related factors [3每5]. A lot has been done for disease awareness under program; the community behavior becomes supportive toward patient. However, evidence also showed that still stigma associated with signs and symptoms of TB, availability of diagnostic, and
%U http://www.hindawi.com/journals/pm/2014/132047/