Evaluation of treatment outcome in extrapulmonary tuberculosis: A mixed method study from Puducherry

Abstract

Background: Extrapulmonary tuberculosis (EPTB) is also a public health problem and involves other parts of the body other than lung. During the quarterly review meeting of State Task Force (STF), Puducherry the members raised concern about the outcome of patients referred from the medical colleges. Even though we receive 60 % feedback of initiation of treatment from the PHI but the treatment outcome of EPTB is not clear. Hence primary agenda of this research was to identify the gap in adherence to diagnostic criteria and treatment.

Aim: To assess the methods adopted for diagnosis of EPTB and to find out the compliance and outcome of the treatment and to identify the patient and health providers related factors that contribute to the outcome of the treatment.

Material and method: Study design: An explanatory mixed method study.

Data collection: The information on methods adopted for diagnosis and category of treatment followed in EPTB was extracted from TB register and patient record sheets from the Medical College. House visits was made to trace the patients and the information related to duration of treatment and the outcome of treatment was found. Free listing was conducted to explore the reasons (facilitating and barriers) contributed to the outcome of the EPTB patients.

Data analysis: Using EpiData (version 3.1, EpiData Association, Odense, Denmark), data was entered and analysed. The qualitative data was entered and analysed using Visual Anthropac (Ver_1.0.1.36; Analytic Technologies, Inc., USA) software package.

Results: More than three-fourth (83.6%) of the patients completed extrapulmonary tuberculosis treatment. The site of EPTB emerged as significant predictor for disease outcome. The most salient facilitating factors and barriers contributed to the outcome of treatment were "periodic reminders and care by the family members" and Side effects such as giddiness, loss of sleep and appetite, discolouration of urine, gastritis, difficulty in breathing and walking, swelling of legs, weight and hair loss and myalgia" respectively.

Conclusion: The study found that there is good compliance and outcome in treatment outcome. Efforts should be made to overcome the barriers to the outcome of treatment.

Keywords: Barriers; Compliance; Extrapulmonary tuberculosis; Facilitating; Healthcare providers; Patients.