Follow-up examinations: are multidrug-resistant tuberculosis patients in Uttar Pradesh, India, on track?
This study aims to determine underlying provider and patient perspectives of follow-up services
Abstract
Setting
All multidrug-resistant tuberculosis (MDR-TB) patients who had completed 6 months of treatment under the Revised National Tuberculosis Control Programme (RNTCP) in Uttar Pradesh, the largest state in northern India.
Objective
To determine the proportion of MDR-TB patients with regular follow-up examinations, and underlying provider and patient perspectives of follow-up services.
Methods
A retrospective cohort study was undertaken involving record reviews of 64 eligible MDR-TB patients registered during April–June 2013 in 11 districts of the state. Patients and programme personnel from the selected districts were interviewed using a semi-structured questionnaire.
Results
A total of 34 (53.1%) patients underwent follow-up sputum culture at month 3, 43 (67.2%) at month 4, 36 (56.3%) at month 5 and 37 (57.8%) at month 6. Themes associated with irregular follow-up that emerged from the interviews were multiple visits, long travel distances, shortages of equipment at the facility and lack of knowledge among patients regarding the follow-up schedule.
Conclusion
The majority of the MDR-TB patients had irregular follow-up visits. Provider-related factors outweigh patient-related factors on the poor follow-up examinations. The programme should focus on the decentralisation of follow-up services and ensure logistics and patient-centred counselling to improve the regularisation of follow up.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
U. C. Tripathi, S. B. Nagaraja, J. P.Tripathy, S. K. Sahu, M. Parmar, K. Rade, S. Bhatnagar, A. Ranjan, K. S. Sachdeva (2015) Follow-up examinations: are multidrug-resistant tuberculosis patients in Uttar Pradesh, India, on track? Public Health Action vol 5 no 1 10.5588/pha.14.0095