Is the Revised National Tuberculosis Control Programme achieving early initiation of treatment post two decades of its operation?: A cross-sectional study from Uttarakhand, India
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https://doi.org/10.47203/IJCH.2019.v31i04.010Keywords:
Tuberculosis, Cough, Health care providers, IndiaDimensions Badge
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Copyright (c) 2019 Indian Journal of Community Health

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Background: Early case finding and prompt initiation of treatment of pulmonary Tuberculosis (PTB) is the most effective strategy to achieve successful TB control. In order to achieve early initiation of treatment, the Revised National TB Control Programme (RNTCP) since its launch in 1997 has been using advocacy, communication and social mobilization (ACSM) strategy targeted at health care providers (HCP) and other stake holders by large scale utilization of electronic and print media. Objective: To study whether RNTCP is really achieving early initiation of TB treatment among infectious PTB patients. Methods: A cross- sectional study among new smear positive PTB patients at Haldwani block of Nainital district of Uttarakhand State of North India. Data was analyzed using the software Epi Info version 7.2.0.1. Results: Of the 85 infectious PTB patients included in the study, the median time consumed between onset of cough and contact with the first HCP, between first HCP contact to confirmation of diagnosis, and between confirmation of diagnosis to initiation of treatment were 6 days, 43 days and 6 days respectively. Overall, median time consumed between onset of cough to initiation of treatment was 61 days. HCPs working in the public health settings fared no better than those in the private health sector in this regard. Conclusions: Although majority patients sought medical care timely, a considerably unacceptable long time was consumed by HCPs in initiation of treatment of PTB.Abstract
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TB India. RNTCP status report. Central TB Division, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India. 2009 Uplekar M, Juvekar S, Morankar S, Rangan S, Nunn P. Tuberculosis patients and practitioners in private clinics in India. Int J Tuberc Lung Dis. 1998;2(4):324-9. Suganthi P, Chadha V K, Ahmed J, Umadevi G, Kumar P, Srivastava R, Magesh V, Gupta J, Sharda M A. Health seeking and knowledge about tuberculosis among persons with pulmonary symptoms and tuberculosis cases in Bangalore slums. Int J Tuberc Lung Dis. 2008; 12(11):1268–1273. Hazarika I. Role of Private Sector in Providing Tuberculosis Care: Evidence from a Population-based Survey in India. Journal of Global Infectious Diseases 2011;3(1):19-24. Sreeramareddy CT, Qin ZZ, Satyanarayana S, Subbaraman R, Pai M. Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review. Int J Tuberc Lung Dis. 2014;18(3): 255–266. Purty AJ, Chauhan RC, Natesan M, Cherian J, Singh Z, Sharma Y. Patient and health system delays among adult smear-positive tuberculosis patients diagnosed at medical colleges of Puducherry in south India. Indian J Public Health 2016;60:77-80 R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2018 Available from https://www.R-project.org/. International Institute of Population Science (IIPS) and macro-international. National family health survey (NFHS-3) 2005-06 India 2007; Vol-1. TB India. RNTCP status report. Central TB Division, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India. 2014. Mistry N, Rangan S, Dholakia Y, Lobo E, Shah S, Patil A. Durations and Delays in Care Seeking, Diagnosis and Treatment Initiation in Uncomplicated Pulmonary Tuberculosis Patients in Mumbai, India. PLoS One. 2016;11(3):e0152287. doi: 10.1371/journal.pone.0152287. eCollection 2016. PubMed PMID: 27018589; PubMed Central PMCID: PMC4809508.[PubMed]. Central TB Division. Involvement of Private Practitioners in the Revised National Tuberculosis Control Programme. Directorate General of Health Services, Ministry of Health & Family Welfare, New Delhi. 2005 Paul D, Busireddy A, Nagaraja SB, Satyanarayana S, Dewan PK, Nair SA, Sarkar S, Ahmed QT, Sarkar S, Shamrao SR, Harries AD, Oeltmann JE. Factors associated with delays in treatment initiation after tuberculosis diagnosis in two districts of India. PLoS One. 2012;7(7):e39040. doi: 10.1371/journal.pone.0039040. Epub 2012 Jul 9. PubMed PMID: 22792161; PubMed Central PMCID: PMC3392255.[PubMed] Kant S, Singh AK, Parmeshwaran GG, Haldar P, Malhotra S, Kaur R. Delay in initiation of treatment after diagnosis of pulmonary tuberculosis in primary health care setting: eight year cohort analysis from district Faridabad, Haryana, North India. Rural Remote Health. 2017 Jul-Sep;17(3):4158. doi: 10.22605/RRH4158. Epub 2017 Jul 20. PubMed PMID: 28727473.[PubMed].
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