Magnitude of initial default in pulmonary tuberculosis.

Abstract

OBJECTIVE: To assess the magnitude and reasons of initial default in pulmonary tuberculosis patients, diagnosed at Nazimabad Chest Clinic, Karachi. METHODS: This prospective study was conducted over five months from 1st December 2007 to 30th April 2008. Suspected tuberculosis patients were prescribed sputum AFB (Acid Fast Bacilli) smears for three samples. This study included the smear positive patients who did not collect their report and were therefore defaulters for initiation of anti-tuberculosis treatment. These patients were contacted on phone, reasons of defaults were enquired and they were offered free treatment. RESULTS: In the study period, out of 869 tuberculosis suspects, 224 were diagnosed as smear positive pulmonary tuberculosis. Of these 224, one hundred and sixty-two got themselves registered for treatment. The remaining 62/224 (27.67%) were initial defaulters. On telephonic contact, 55 (88.70%) were traceable while 07/62 (11.29%) were Untraceable-defaulters. Twenty-four patients (38.70%) reported to the clinic and were registered for treatment. The most common reason for default was 'dissatisfaction with services at the clinic'. CONCLUSION: A high initial default for initiating Anti-Tuberculosis Therapy is a serious issue that needs to be addressed.