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Abstract
Background: There are numerous public health and clinical consequences of incomplete TB treatment. Treatment with second-line drugs is less successful and more toxic. Relapse and treatment failure are also an important problem because patients can harbor drug resistant mycobacterium tuberculosis bacilli.
Objective: To explore the patients', care givers', DOTS providers' perspective about factors associated with loss to follow up, relapse and treatment failure in tuberculosis patients.
Materials and Methods: This phenomenological study was conducted on 12 patients', 11 care givers' and 12 DOTS providers' involved in screening, treatment of patients at DOTS centres, U.T. Chandigarh. Purposive sampling technique was used for data collection. A pre validated semi structured interview guide was used to collect the data. In-depth interviews were conducted. Audio recording was done following permission from the participants. Principle of redundancy was followed for data collection.
Results: Based on patients verbatim 12 themes were formulated. 12 themes were formulated from verbatim provided by care givers. Based on DOTS providers' verbatim, 7 themes were formulated. Each theme was further divided in to various sub-themes to categorize the information more appropriately.
Conclusion: This study has demonstrated many factors responsible for loss to follow up, treatment failure and relapse in TB patients. Although medicines are provided free of cost but side effects of medicines and pill burden was a disabling factor in completion of treatment. In congruence with this, low socio-economic status, family liabilities, awareness issues and burden of losing income from work contributes to non-compliance. Occupational exposure of irritants, addictions, imbalanced diet, primary resistance, co-morbidities and non compliance to treatment contributes treatment failure and relapse of disease. Patients and care givers were knowledge deficit related to disease and course of treatment. DOTS providers had job dissatisfaction due to financial issues.
