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Epidemiology and policy
P1-296 Case-finding and treatment of TB patients in medical colleges in pondicherry, S. India: patient and health system delays under the revised national TB control programme (RNTCP)
  1. A J Purty1,
  2. Z Singh1,
  3. K H Kisku3,
  4. J Bazroy1,
  5. N Murugan1,
  6. J Cherian1,
  7. A Senthilvel1,
  8. S Govindarajan2
  1. 1Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India
  2. 2State TB Control Officer, Government of Pondicherry, Pondicherry, India
  3. 3Chest Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India

Abstract

Introduction Early diagnosis of TB and prompt initiation of treatment is essential for an effective tuberculosis control programme. Delay in the diagnosis may worsen the disease, increase the risk of death and enhance tuberculosis transmission in the community.

Objectives

  1. To study the factors associated with case finding and treatment of TB patients under RNTCP in Medical colleges of Puducherry.

  2. To study the referral and feedback mechanism under RNTCP in and around Puducherry.

Material & Methods From the 875 TB patients diagnosed at four Medical colleges during 2009, we selected 324 patients by systematic random sampling and could contact 216. They were personally interviewed by trained field health workers, using a semi-structured questionnaire.

Results The study group had 147 (68%) males and 69 (32%) females. 140 (64.5%) were receiving Cat I, 45 (20.5%) Cat II, 30 (13.5%) Cat III and 1 (0.5%) Cat IV treatment. The mean and median patient delay was 59.2 (SE 5.7) and 36.5 days, diagnosis delay was 37.2 (SE 4.9) and 12 days, treatment delay was 24.2 (range 7–90) and 18 days, health system delay was 44.1 (range 7–90) and 31 days and the total delay was 84.2 (range 17–140) and 74 days. Longer delays were not associated with knowledge about availability of DMC's but were associated with accessibility of diagnostic/treatment facilities. Impact on Policy: Regular sensitisation is required for medical personal in private health sectors where large number of patients seek treatment and RNTCP in Puducherry requires strengthening to reduce patient and health system delays.

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