Determinants of adverse treatment outcomes among patients treated under Revised National Tuberculosis Control Program in Wardha, India: Case-control study

Med J Armed Forces India. 2018 Jul;74(3):241-249. doi: 10.1016/j.mjafi.2017.07.008. Epub 2017 Sep 1.

Abstract

Background: Tuberculosis (TB) leads to a considerable loss of lung functions and Quality Adjusted Life Years. Several factors are associated with adverse treatment outcomes from TB which further increases this loss. We undertook the study to study the determinants of adverse treatment outcomes among tuberculosis patients treated under the Revised National Tuberculosis Control Program in a tuberculosis unit in India.

Methods: 88 cases and 187 controls from among patients registered in Wardha Tuberculosis Unit in the year 2014 were interviewed to study the determinants of adverse treatment outcomes of tuberculosis. All patients with adverse treatment outcomes were taken as cases. Controls were chosen from relapse free successfully treated patients using simple random sampling.

Results: On multivariate analysis indoor air pollution, pulmonary TB, discrimination due to TB and poor satisfaction with services significantly increased the odds of adverse treatment outcomes whereas the senior treatment supervisor visiting the patients during treatment was protective.

Conclusion: Appropriate new interventions and strengthening of the existing mechanisms to reduce treatment interruptions along with proper implementation of the program will help in reducing the adverse treatment outcomes and improving program performance.

Keywords: Discrimination; Indoor air pollution; Satisfaction; Senior treatment supervisor; Tuberculosis unit.