Magnitude and determinants of adverse treatment outcomes among tuberculosis patients registered under Revised National Tuberculosis Control Program in a Tuberculosis Unit, Wardha, Central India: A record-based cohort study.
Deaths, defaults, relapses, and treatment failures have made the control of TB difficult across the globe.



This study is a record-based follow-up of a cohort of patients registered under Revised National Tuberculosis Control Program in the year 2014 in Wardha Tuberculosis Unit, India. Data was collected from the records available at the District Tuberculosis Office.



Data of 510 patients was analyzed. The sputum conversion rate was 88%. The overall treatment success rate was 81.9%, and rates of any adverse outcome, deaths, defaults, failure, and shift to Category IV regimen were 32.60/100 person years at risk (PYAR), 16.88/100 PYAR, 11.12/100 PYAR, 3.45/100 PYAR, and 1.15/100 PYAR, respectively. The median times for the above outcomes were 81days, 110days, 66days, 118days, and 237days, respectively. The cumulative probability of occurrence at 6months of any adverse outcome, deaths, default, failure, and shift to Category IV regimen was 0.145, 0.056, 0.088, 0.002, and 0.004, respectively. On multivariate analysis, the determinant of any adverse outcome was age >45years, whereas extrapulmonary disease was protective. The hazard of defaulting was also significantly higher in male patients and those aged >45years.



Appropriate interventions and program implementation to reduce the adverse treatment outcomes and interruptions will help in improving program performance.
Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India. Electronic address: anuj.mundra87@gmail.com.
Anuj
A
Mundra
Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India.
Pradeep R
PR
Deshmukh
District Tuberculosis Office, Wardha, India.
Ajay
A
Dawale
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation / Q000706:statistics & numerical data*; D012307:Risk Factors; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy*; D055815:Young Adult
D000995:Antitubercular Agents
DOTS; Survival probability; Treatment adherence; Treatment outcomes