Prevalence and Factors Associated with Default Registration of Treatment among New Smear Positive Pulmonary Tuberculosis Patients in Yasothon Province, 2010

Abstract

The objectives of this study were to investigate the prevalence and factors
associated with default registration of treatment among new smear positive
pulmonary tuberculosis (PTB) patients at the Yasothon Province. The investigation
was conducted as a cross‐sectional analytical study during January 1, 2010 to
December 31, 2010. Two data sources had been used, namely TB laboratory records
from a TB register of nine public hospitals and the results of a questionnaire derived
from interviewing patients providing individual information. Those who were
classified as ‘default registration’ were interviewed at home. For statistical analysis,
the STATA 10.0 software program was used. Descriptive statistics were used to
describe the characteristics of patients and the prevalence rate. Multivariable
logistic regression was used for identification risk factors and the values of adjusted
OR (ORadj), together with the 95% confidence intervals (95% CI). All together 348
patients with new smear positive PTB were identified and the prevalence rate for
the province was estimated to be 66.4 per 100,000 population. The PTB 250 cases
were registered and the default of registration was 28.2% (98 cases), the death rate
was 9.2% and data from the deceased could be collected from 80.6% (79 cases).
Evaluating Default registration in detail males for often (26.5%) did not follow up
treatment in comparison to females (18.8%). Those failed to come for treatment
mostly were in the age of 30‐34 years (37.5%, mean=52.3±15.6 years), and 68.8%
of them were jobless. By multiple logistic regression analysis, factors associated
with default registration of new smear positive TB patients were that they were not
visited at home (ORadj=77.68; 95%CI=24.37‐247.56), had hypertension
(ORadj=48.24; 95%CI=4.11‐565.35), were jobless (ORadj=11.92; 95%CI=1.51‐94.05),
and were diagnosed at a place with a not functioning reference system
(ORadj=10.74; 95%CI=3.92‐29.42) and used to drink alcohol (ORadj=3.68; 95%CI
=1.13‐11.93). This study points towards two major issue, namely the lack of home
visits and a functioning reference system, related to default registration of newly
detected patients with TB. Both factors are which are related to shortcomings of the
health delivery system and cannot be readily blamed on individual neglicance. To
see in the functioning of home visits and to organize a functioning reference system
are the duty of the health care providers and should be corrected.