Factors Affecting Treatment Compliance among Tuberculosis Patients at Dots Centre after Introduction of Daily Regimen and Fixed Dose Combination.

DOTS under National Tuberculosis elimination Program have shown to be highly effective, but poor compliance remains a challenge to the TB programs and is a major threat to development of drug resistant tuberculosis. Objective of this study was to describe the factors determining compliance to treatment and timing of treatment interruption. MATERIAL: Information was collected from TB register and treatment cards of drug sensitive tuberculosis patients registering for treatment at DOTS center during study period at -Mandya institute of medical sciences, Mandya. Patients completed treatment during the year January 2018 to January 2020 were interviewed during there last visit to DOTS centre or during there follow up visit to elicit the reason for non compliance using a structured proforma. OBSERVATION: A total of 162 patients were enrolled, 95 male, 66 female and 1 transgender, 157 new TB patients and 5 were previously treated Drug sensitive TB patients were included (131 of pulmonary tuberculosis, 31 of extra-pulmonary tuberculosis). Out of 166, 89 were compliant, 63 were non compliant, 10 patients died during the treatment. Of 63 non compliant, 12 were lost to follow up (called defaulters previously) and 51 interrupted treatment for more than one day but less than one month. More than one reason was often reported for discontinuation of treatment and most interruptions occurred in early part of continuation phase. Among factors determining compliance, interruption was more common in males(58.6%) than females(40.7%). Early improvement (30.05%) and addictive habits 16.39%)were found to be the two most common reasons, followed by unaware long duration of treatment, long distance to travel, drug related side effects and forget fullness are the causes leading to treatment interruption. whereas effective counseling by doctor and proper instructions by health care workers were the most common reasons for maintaining compliance. CONCLUSION: compliance still remains the major factor in treatment of tuberculosis, doctors and health care workers can play a major role in this by doing effective counseling and providing proper instructions to the patients about treatment of TB. Particularly during the time when patient feels he is becoming better and no longer needs treatment. Also addressing the addictive habits is important in preventing treatment interruption.