ISSN: 0976-3325 National Journal of Community Medicine 2010, Vol. 1, Issue 2 71 Original Article AN EVALUATION OF THE TREATMENT BEHAVIOR OF THE PATIENTS ON DOTS OF ANAND DISTRICT, GUJARAT Donald Christian 1 , Uday Shankar Singh 2 , Sidhyartha Mukherjee 3 , Deepak Sharma 4 1 Assistant Professor, Department of Community Medicine, SBKS Medical Institute & Research Center, Piparia, Waghodia, Gujarat 2 Professor 3 Professor & Former Head of Department 4 Assistant Professor, Department of Community Medicine, Pramukhswami Medical College, Karamsad. Correspondence: donald_christian2002@yahoo.com ABSTRACT Background: To achieve goals of RNTCP, issues like treatment adherence & treatment behavior of TB (Tuberculosis) patients taking DOTS should also be focused, considering long duration of drug therapy. Objective: To analyze various factors that could affect the treatment behavior during the course of DOTS among the patients attending the TB units. Material & Methods: Design: Cross-sectional study, Participants: 100 diagnosed TB patients on DOTS, from all TB units (25 from each TU) of Anand District, who had reported to health center at least after 3 weeks of initiation of symptoms. Information was filled up in a pre-tested questionnaire. Results: A total 100 TB patients (68 males, 32 females) were interviewed; among which, 29% were illiterate and 46% were laborer. 24% of the subjects had any side- effect. Social stigma was faced by 10% of subjects (6 males, 4 females). 16% of the respondents had a treatment interruption during current treatment. The commonest reason for treatment interruption was “thought of being cured” (75%). Conclusion: The treatment behavior of the patients on DOTS also depends on various social-economical characteristics. The issues of side-effects of drugs and “thought of being cured” also need to be focused. Health system changes in terms of efficient staff and adequate drugs should also be considered. Key words: treatment behavior, DOTS patients, social stigma, side effects of DOTS drugs, treatment interruption. INTRODUCTION Tuberculosis is a worldwide, chronic communicable bacterial disease. It is a strange disease because of its varied clinical presentation, host response, chemotherapeutic response, etiology and social implications. Because of which community suffers from economic, social and health burden. India accounts for nearly 1/3 rd of the global burden of tuberculosis. Indirectly, every year more than 17 crore work-days are lost due to tuberculosis at the above mentioned cost (Rs.12,000 crore per year). 1 Once patient is put on treatment, adherence to treatment becomes very important aspect of the DOTS as the duration of therapy is long and often the patients have a low socio-economic profile. There could be many determining factors which ultimately decide treatment behavior of the patient on DOTS. The study tries to find out few of the factors which had a bearing on treatment behavior of such patients. Objective: To analyze various factors that could affect the treatment behavior during the course of DOTS among the patients attending the TB units. MATERIALS AND METHODS Methodology of the study: A cross sectional study was carried out among hundred diagnosed TB patients on DOTS who were taking treatment from one of the four TB units of Anand district, namely Petlad, Khambhat, Anklav & Sarsa. The study period was for in total of about a year during 2008-09. The sample size of 100 was based on a type of non-probability sampling, purposeful sampling, as the study aimed at finding out behavior characteristics. Study population: After the approval of the project from the institutional research ethic committee, four TB units in the district were approached. Medical Officer in charge of the concerned TB unit was consulted and objective of the study was explained. From each TB unit, 25 patients were identified, who had reported 3 weeks or later to the health centre. The patients were visited at their residence to provide appropriate privacy and time for the interview. Consent of the subject regarding their participation in the study was obtained before head. Inclusion criteria: Patients diagnosed with TB who had reported to the health center at least after 3 weeks from the onset of symptoms related to TB and had given informed consent to take part in the study. The data were analyzed by making frequency tables