Initial defaulting in the National Tuberculosis Programme in Ho Chi Minh City, Vietnam: a survey of extent, reasons and alternative actions taken following default.
METHODS
Ho Chi Minh City, Vietnam.


OBJECTIVE
To determine the extent of initial default in the NTP, the reasons for initial default, health seeking after initial default and treatment received at other health facilities.


METHODS
Questionnaire-based interviews of patients who were diagnosed with sputum-positive TB in the NTP during 2000 and who did not register for treatment in the NTP.


RESULTS
The initial default rate was 8.3%; 79% gave reasons related to the NTP working procedures or treatment strategy, while 17.5% gave reasons related to insufficient knowledge among patients about TB and/or the need for treatment. Sixty-five per cent had been treated with anti-tuberculosis drugs at other health facilities after default, of which 74% had been treated at fully private facilities.


CONCLUSIONS
Initial default is mainly caused by some patients' negative perceptions of working procedures and/or treatment strategy in the NTP. The majority of these patients are treated in private clinics after default from the NTP. The NTP needs to improve patients' perceptions of the treatment strategy and develop more user-friendly services that enable more patients to access treatment and reduce the risk of patients receiving substandard treatment in the private sector.
Buu
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TN
Pham Ngoc Thach TB and Lung Disease Hospital, Ho Chi Minh City, Vietnam.
Lönnroth
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K
Quy
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HT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009313:National Health Programs; D010352:Patient Dropouts; D010358:Patient Participation; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D014744:Vietnam
D000995:Antitubercular Agents