Reasons for the delay in the initiation of treatment and initial default among drug-resistant tuberculosis patients in Ahmedabad corporation area

Indian J Public Health. 2019 Oct-Dec;63(4):377-379. doi: 10.4103/ijph.IJPH_26_19.

Abstract

The emergence of drug-resistant tuberculosis (DR-TB) has become a significant health problem in India. Delays in diagnosis and treatment initiation are frequently observed among patients with DR-TB, resulting in an increased risk of disease complications and high mortality and pretreatment lost to follow-up rates. To understand the factors associated with delays between the diagnosis and treatment, the study was carried out in Ahmedabad Municipal Corporation Area. A total of 177 DR-TB patients diagnosed in the year 2014 who had a delay in the initiation of treatment, and 23 initial defaulters were studied using a structured questionnaire. Fifty-four DOTS providers were also interviewed. Of 177 patients, 62.15% initiated treatment between 7 and 15 days and nearly 12% of them started the treatment after a month. The median duration of delay was 12 days (range: 8-144 days and interquartile range: 9-20 days). The most common reason for the delay in the initiation and initial default was the social and personal factors (48.80%), and in 34 (20%) of the patients, the delay was attributed to the effect of the previous treatment.

Keywords: Defaulter; delay; drug resistant; treatment; tuberculosis.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use*
  • Delayed Diagnosis* / statistics & numerical data
  • Female
  • Humans
  • India
  • Male
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Young Adult

Substances

  • Antitubercular Agents