Srinath Satyanarayana|Sreenivas Achuthan Nair|Sarabjit Chadha|Roopa Shivashankar|Gopal Sharma|Subhash Yadav|S. Mohanty|Vishnuvardhan Kamineni|Nevin Wilson|Anthony Harries|Puneet Dewan
From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
International Union Against Tuberculosis and Lung Disease|Centre for Chronic Disease Control|London School of Hygiene & Tropical Medicine|International Union Against Tuberculosis and Lung Disease|World Health Organization - India
background tuberculosis tb notification india revised national tb control programme rntcp provides information tb patients registered treatment programme limited information proportion patients treated tb outside rntcp patients access treatment objectives estimate proportion patients accessing tb treatment outside rntcp identify basic demographic characteristics methods cross sectional communitybased survey 30 districts patients identified doortodoor survey interviewed using semistructured questionnaire results estimated 75000 households enumerated 73249 households 976 visited 371174 household members 761 tb patients identified 205 cases per 100000 populations data collected 609 80 tb patients 331 54 95 ci 4266 determined taking treatment dotsrntcp remaining 278 46 95 ci 3457 treatment outside dotsrntcp sources hence unlikely part tb notification system patients accessing treatment outside dotsrntcp likely patients rural areas adjusted odds ratio aor 25 95 ci 1253 whose tb diagnosed nongovernment health facility aor 140 95 ci 79249 conclusions communitybased survey found nearly half selfreported tb patients missed tb notification system districts study highlights need 1 reviewing revising scope tb notification system 2 strengthening monitoring health care delivery systems periodic assessment reach utilisation rntcp services especially among rural communities 3 advocacy communication social mobilisation activities focused rural communities low household incomes 4 inclusive involvement healthcare providers especially providers poor rural communities