TO STUDY THE FACTORS RESPONSIBLE FOR FAILURE TO INITIATE TUBERCULOSIS TREATMENT AMONG SMEAR POSITIVE TUBERCULOSIS PATIENTS

ABSTRACT          

Aims:  To see the factors responsible for not starting the TB treatment among smear positive TB patients and suggest measures to combat this.

Settings: This cross sectional study was done at PMRC TB Research Center, KEMU, Lahore, from 5^th March 2010 to 5^th December 2010.           

Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and hence not initiated their anti tuberculosis treatment was contacted using their telephone numbers and traced by their home addresses. Patients contacted telephonically were offered bus/local transport fare according to the distance from hospital and others were followed on their given addresses. Their socieodemographic breakup, educational level and reason for not strating anti TB treatment were inquired using a questionnaire.

Results: A total of 50 patients were contacted. Socioeconomic status showed that 38 (76%) patients belonged to the lower socio economic class and 12 (24%) to the lower middle class. Educational status showed that 14 (28%) patients were illiterate and 23 (46%) had education below middle. Of 50 cases 41 (82%) patients were taking treatment from traditional healers and 4% subjects did not go back to the DOTS program as they were unsatisfied with the over all conditions that were provided by DOTS for medicine. 

Conclusions: Lack of health education and poverty were the main factors responsible for non compliance for treatment. Physical condition of the patient, socio demographic, cultural and religious issues also played a role in treatment default. Management of TB treatment from quacks needs to be urgently addressed and patient should be made aware about the disease from the start of treatment till completion of therapy.