Treatment success rates among tuberculosis patients notified from the private sector in West Bengal, India

Submitted: August 8, 2020
Accepted: December 11, 2020
Published: February 2, 2021
Abstract Views: 1408
PDF: 559
Supplementary: 118
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

In India, an estimated 50% of tuberculosis (TB) patients are diagnosed and managed by private providers (PPs). However, there is limited information on treatment outcomes among those treated by PPs largely because of a lack of systems for patient follow-up and documentation of the outcomes. Tuberculosis Health Action Learning Initiative (THALI) project implemented in six districts of West Bengal, supported PPs in managing TB patients and systematically documented the TB treatment outcomes of such patients. This provided us an opportunity to describe the treatment outcomes and assess factors associated with ‘unsuccessful outcomes’ among TB patients notified by PPs from January to April 2018. This was a retrospective cohort study using routinely collected data. During the study reference period, 2347 patients were notified from 389 PPs. The patient’s mean (SD) age was 39.9 (17.2) years and 61% were males. Of the total, about 86% had pulmonary TB, 95% were new cases, and 23% were microbiologically confirmed (either on sputum smear microscopy or Xpert assay). Among 2347 patients, 19% received free drugs from the National Tuberculosis Program (NTP) under the supervision of PPs while the rest purchased anti-TB drugs from the private pharmacies. The ‘successful outcomes’ (cured and treatment completed) were seen in 86.1% (95% confidence interval (CI), 84.6%-87.4%) patients and 8.6% were ‘not evaluated’. The patients who received free NTP drugs (adjusted relative risk-4.0 (95% CI: 3.1-5.0)) had a higher risk of ‘unsuccessful outcomes’ than those who availed of drugs from private pharmacies. The high ‘successful outcomes’ among TB patients treated by PPs are promising. However, higher ‘unsuccessful outcomes’ among patients on free NTP drugs need to be explored, and suitable corrective actions have to be taken.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

WHO. Global tuberculosis report 2019. [cited 2019 Jun 11]. Available from: https://apps.who.int/iris/bitstream/handle/10665/329368/9789241565714-eng.pdf
Saha I, Paul B. Private sector involvement envisaged in the National Strategic Plan for Tuberculosis Elimination 2017–2025: Can Tuberculosis Health Action Learning Initiative model act as a road map? Med J Armed Forces India 2019;75:25-7.
Suganthi P, Chadha VK, Ahmed J, et al. Health seeking and knowledge about tuberculosis among persons with pulmonary symptoms and tuberculosis cases in Bangalore slums. Int J Tuberc Lung Dis 2008;12:1268–73.
Uplekar M, Juvekar S, Morankar S, et al. Tuberculosis patients and practitioners in private clinics in India. Int J Tuberc Lung Dis 1998;2:324–9.
Cazabon D, Alsdurf H, Satyanarayana S, et al. Quality of tuberculosis care in high burden countries: the urgent need to address gaps in the care cascade. Int J Infect Dis 2017;56:111–6.
Satyanarayana S, Subbaraman R, Shete P, et al. Quality of tuberculosis care in India: a systematic review. Int J Tuberc Lung Dis 2015;19:751–63.
Das J, Kwan A, Daniels B, et al. Use of standardised patients to assess quality of tuberculosis care: a pilot, cross-sectional study. Lancet Infect Dis 2015;15:1305–13.
Bronner Murrison L, Ananthakrishnan R, Sukumar S, et al. How Do urban indian private practitioners diagnose and treat tuberculosis? A cross-sectional study in Chennai. PLoS One 2016;11:e0149862.
Ismail I, Bulgiba A. Determinants of unsuccessful tuberculosis treatment outcomes in Malaysian HIV-infected patients. Prev Med 2013;57:S27-30.
Kaur G, Goel NK, Kumar D, et al. Treatment outcomes of patients placed on treatment under directly observed therapy short-course (dots). Lung India 2008;25:75-7.
Adejumo O, Daniel O, Otesanya A, et al. Evaluation of outcomes of tuberculosis management in private for profit and private-not-for profit directly observed treatment short course facilities in Lagos State, Nigeria. Niger Med J 2017;58:44.
Kunoor A, James PT, Raj M, et al. Outcomes of patients treated with individualised anti-tuberculosis regimens in a tertiary care centre in India. Public Heal action 2017;7:308.
Fernandez L, Garcia JF, Monroy K, Munoz CA. Treatment outcomes of tuberculosis patients: Cohort 2014 in a private sector in Cali, Colombia. Am J Respir Crit Care Med 2020;201:A5527.
Anand T, Babu R, Jacob A, et al. Enhancing the role of private practitioners in tuberculosis prevention and care activities in India. Lung India 2017;34:538.
Central TB Division, Directorate General of Health Services. India TB Report 2018. Ministry of Health and Family Welfare [Internet]. 2018. Available from: https://tbcindia.gov.in/showfile.php?lid=3314

Ethics Approval

The study was approved by the Ethics Advisory Group of the International Union Against Tuberculosis and Lung Disease, Paris, France. Formal written permission was taken from the State TB officer, where the study had been conducted
Pruthu Thekkur, Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris

The Union South East Asia Office (The USEA), New Delhi, India

Srinath Satyanarayana, Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris

The Union South East Asia Office (The USEA), New Delhi, India

How to Cite

Sharma, Vivek, Pruthu Thekkur, Poonam R. Naik, Brojo Kishore Saha, Niraj Agrawal, Milan K. Dinda, S. Parthiban, et al. 2021. “Treatment Success Rates Among Tuberculosis Patients Notified from the Private Sector in West Bengal, India”. Monaldi Archives for Chest Disease 91 (1). https://doi.org/10.4081/monaldi.2021.1555.

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.