Research Article Factors Influencing Early Health Facility Contact and Low Default Rate among New Sputum Smear Positive Tuberculosis Patients, India Ashok Kumar Bhardwaj, 1 Surender Kashyap, 2 Pradeep Bansal, 1 Dinesh Kumar, 1 Sunil Kumar Raina, 1 Vishav Chander, 1 and Sushant Sharma 1 1 Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh 176001, India 2 Kalpana Chawla Government Medical College, Karnal, Haryana, India Correspondence should be addressed to Dinesh Kumar; dinesh9809@gmail.com Received 13 November 2013; Revised 3 February 2014; Accepted 4 February 2014; Published 6 March 2014 Academic Editor: Hisako Matsumoto Copyright © 2014 Ashok Kumar Bhardwaj et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Early case identifcation and prompt treatment of new sputum smear positive case are important to reduce the spread of tuberculosis (TB). Present study was planned to study the associated factors for duration to contact the health facility since appearance of symptoms and treatment default. Methodology. It was prospective cohort study of TB patients already registered for treatment in randomly selected TB units (TUs) in Himachal Pradesh, India. Relative risk (RR) was calculated as risk estimate to fnd out the explanatory variables for early contact and default. Results. Total 1607 patients were recruited and 25 (1.5%) defaulted treatment. Patients from nuclear family (aRR: 1.37; 1.09–1.73), ashamed of TB (aRR: 1.32; 1.03–1.70), wishing to disclose disease status (aRR: 1.79; 1.43–2.24), but aware of curable nature (aRR: 1.67; 1.17–2.39) and preventable (aRR: 1.35; 1.07–1.70) nature of disease, contacted health facility early since appearance of symptoms. Conclusion. Better awareness and less misconceptions about disease infuences the early contact of health facility and low default rate in North India. 1. Introduction One-third of the world population is infected with Mycobac- terium tuberculosis causing disease in about 10 million indi- viduals and resulting in 1.3 million deaths per year. Asia and Africa regions together share 85.0% of the global disease burden [1]. India notifed total 1.3 million cases including 0.62 million sputum smear positive cases [2]. Evidence from India showed that tuberculosis (TB) contributes about 30% of deaths due to communicable disease and 7% of total deaths [2]. Based upon World Health Organization (WHO) recommendations, the Government of India implemented Directly Observed Treatment Short Course (DOTS) strategy under Revised National Tuberculosis Program (RNTCP) [2]. Since then, treatment success rate among sputum smear positive patients improved from 25% in the year 1985 to about 90% by the year 2011 [2] as compared to the global treatment success rate of 84% [1]. Early case detection and treatment is a public health principle for disease control. Under RNTCP, an awareness campaign for signs and symptoms of TB demands an early contact of health facility for diagnosis. Contact of patient to health facility for treatment compliance depended on the program and patient related factors [3–5]. A lot has been done for disease awareness under program; the community behavior becomes supportive toward patient. However, evidence also showed that still stigma associated with signs and symptoms of TB, availability of diagnostic, and treatment services under RNTCP. Patients tend to hesitate and choose not to disclose their disease status to their family/friends out of fear of being socially marginalized [3– 6]. Te nature and degree of infuence of such factors on health facility contact and so compliance for DOTS have not been reported as ofen. Terefore, the present study was planned to understand the role of factors in contacting Hindawi Publishing Corporation Pulmonary Medicine Volume 2014, Article ID 132047, 5 pages http://dx.doi.org/10.1155/2014/132047