Indian Journal of Public Health

LETTER TO EDITOR
Year
: 2017  |  Volume : 61  |  Issue : 1  |  Page : 58-

Patient and health system delays among adult smear-positive tuberculosis patients at medical colleges of Puducherry in South India: A comment


Madhavi Bhargava 
 Assistant Professor, Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India

Correspondence Address:
Madhavi Bhargava
Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Deralakatte, Mangalore - 575 018, Karnataka
India




How to cite this article:
Bhargava M. Patient and health system delays among adult smear-positive tuberculosis patients at medical colleges of Puducherry in South India: A comment.Indian J Public Health 2017;61:58-58


How to cite this URL:
Bhargava M. Patient and health system delays among adult smear-positive tuberculosis patients at medical colleges of Puducherry in South India: A comment. Indian J Public Health [serial online] 2017 [cited 2019 Oct 20 ];61:58-58
Available from: http://www.ijph.in/text.asp?2017/61/1/58/200247


Full Text

Sir,

I read with interest the article on delays at patient and health system level among smear-positive tuberculosis by Purty et al.[1] The authors have pointed out the extent of delays in the diagnosis and treatment in sputum positive patients. The fact that 40.7% patients were earning international normalized ratio ≤2000/month and another 35.2% did not have steady income source is very significant. It definitely reinforces the importance of addressing social determinants in any tuberculosis control program.[2] Further considering the prevalence of multidrug-resistant tuberculosis (MDR-TB) in India, as 3% in new cases and 12%–17% in retreatment cases,[3] the implications on transmission of MDR-TB in the community are worrisome. This calls for the strengthening of airborne infection control in India, which is far from ideal.[4]

As far as methodology is concerned, it needs to be pointed out that the sample size calculation should have taken into consideration the incidence of tuberculosis in Tamil Nadu and Puducherry (the states from which the patients were enrolled), as done in the Eastern Mediterranean Region study in seven countries.[5] This is especially because the delay is not in terms of prevalence but in terms of duration.

Nevertheless, the study is an important one paving way for operational research to explore important determinants of delays in diagnosis and treatment of tuberculosis in India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Purty AJ, Chauhan RC, Natesan M, Cherian J, Singh Z, Sharma Y. Patient and health system delays among adult smear-positive tuberculosis patients diagnosed at medical colleges of Puducherry in South India. Indian J Public Health 2016;60:77-80.
2World Health Organization. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-resistant Tuberculosis. Geneva, Switzerland: World Health Organization; 2014.
3TB Statistics India; 2012. Available from: http://www.tbfacts.org/tb-statistics-india.html. [Last accessed on 2016 May 01].
4Parmar MM, Sachdeva KS, Rade K, Ghedia M, Bansal A, Nagaraja SB, et al. Airborne infection control in India: Baseline assessment of health facilities. Indian J Tuberc 2015;62:211-7.
5Bassili A, Seita A, Baghdadi S, Al Absi A, Abdilai I, Agboatwalla M, et al. Diagnostic and treatment delay in tuberculosis in 7 countries of the Eastern Mediterranean Region. Infect Dis Clin Pract 2008;16:23-35.