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Free Content Source of retreatment cases under the Revised National TB Control Programme in Rajasthan, India, 2003

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Abstract:

BACKGROUND: Three years after state-wide DOTS coverage and achievement of global targets for detection and cure, the proportion of sputum-positive retreatment cases remained high in the north Indian state of Rajasthan.

AIM: To determine source, accuracy of categorisation and treatment outcomes in Category II sputum-positive retreatment cases registered from January to March 2003 in five districts of Rajasthan.

MATERIAL AND METHODS: Two hundred consecutive Category II sputum-positive retreatment cases were identified from the tuberculosis register and interviewed using a semi-structured questionnaire.

RESULTS: Categorisation was correct in 195 (97.5%) of retreatment cases interviewed. Treatment after default (TAD) comprised 84.6% (165/195) of interviewees, with 13.3% (n = 26) relapses and 2.1% (n = 4) failure cases. Of the TAD cases, 84.8% (n = 140) had defaulted from previous treatment in the private sector. Only 6.1% (n = 10) had defaulted from Category II DOTS treatment. The most unfavourable treatment outcome seen amongst interviewees was default, as also described in the national data.

CONCLUSION: TADs constituted the majority of interviewed retreatment cases (84.6%), and were overwhelmingly being generated by irregular treatment in the private sector. Further involvement of the private sector in the DOTS programme in Rajasthan is needed to stop the creation of further retreatment cases.

Keywords: Category II retreatment cases; RNTCP; directly observed treatment; tuberculosis control

Document Type: Regular Paper

Affiliations: 1: Formerly of State TB Cell, Ministry of Health, Jaipur, Rajastan, India 2: Office of the World Health Organization Representative to India, New Delhi, India 3: Central TB Division, Directorate of General Health Services, Ministry of Health and Family Welfare, New Delhi, India 4: Stop TB Department, World Health Organization, Geneva, Switzerland

Publication date: December 1, 2006

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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