Factors associated with treatment outcome in adult tuberculosis patients under directly observed treatment short course in Ludhiana city, Punjab, India: a cohort study

Background: Tuberculosis (TB) is a communicable disease requiring prolonged treatment and poor adherence to a prescribed treatment increases the risk of morbidity, mortality and spread of disease in the community. Objective was to study factors associated with treatment outcome in adult Tuberculosis patients on directly observed treatment short (DOTS) course in Ludhiana city, Punjab, India. Methods: The present study was a community based prospective cohort study. It was conducted in the two tuberculosis units (TU) of Ludhiana city, Punjab, India. A total of 221 registered DOTS patients were taken as study subjects and were followed during the course of treatment to observe their treatment outcome. The information was collected on a pre-designed semi-structured questionnaire through personal interviews. Results: Out of 221, 183 (82.8%) subjects had favorable outcome, 35 (15.8%) had unfavourable outcome and 3 (1.4%) were transferred out. The comparison between favorable and unfavourable treatment was found be statistically significant with respect to different age groups, problems faced by subjects to reach DOTS centre, diabetes, sputum smear status, site of tuberculosis involvement and side effects of treatment. Conclusions: Elderly and diabetic patients were found to have higher unfavourable outcome. There is need for special provisions for older age groups, illiterates and for lower socio-economic status (SES) in the form of counselling for old people and health insurance for those belonging to lower SES. Keeping in mind the default rate of the present study, initial counselling, periodic motivation of patients and prompt defaulter retrieval action would be beneficial.