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Dr. Dhrubo Jyoti Sen
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Abstract

MEASURING THE “TIME GAP” BETWEEN THE DATE OF DIAGNOSIS AND TREATMENT INITIATION AND ITS EFFECT ON THE TREATMENT OUTCOMES OF TUBERCULOSIS – A SECONDARY DATA ANALYSIS FROM CENTRAL RURAL INDIA

R. Naveen Shyam Sundar* and Mohnish Y. Giri

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Abstract

Tuberculosis (TB) remains a significant public health challenge globally, with India bearing a substantial burden. This study, conducted in Wardha district, Maharashtra, aims to investigate the time gap between TB diagnosis and treatment initiation and its impact on treatment outcomes. Analyzing data from the Revised National Tuberculosis Control Programme (RNTCP) for the period January 2017 to August 2019, we focused on 4,551 patients. The study revealed that despite India's widespread adoption of the WHO Directly Observed Treatment Short course (DOTS) strategy, there is an ongoing challenge in achieving prompt treatment initiation. The age distribution of TB cases showed a predominance among adolescents and the working-age population, with males being more affected than females. The study identified a median time gap between diagnosis and treatment initiation, emphasizing the importance of timely intervention. The analysis of treatment outcomes, stratified by the time gap, revealed intriguing findings. Patients initiated on treatment within 7 days had lower odds of death and treatment completion within the first week compared to later initiation. However, the odds of being cured were higher when treatment was initiated after 7 days, suggesting a complex relationship between time and specific treatment outcomes. Stratifying the data by diagnosing health facility, sex, and age provided additional insights. Public health facilities demonstrated a significantly lower likelihood of initiating treatment within 7 days compared to private institutions, highlighting challenges within the public healthcare system. Males had a slightly lower likelihood of early treatment initiation than females, and age stratification indicated variations, with the 18-60 age group showing a higher likelihood of timely initiation. In conclusion, the study underscores the need for targeted interventions to reduce delays in treatment initiation, particularly in public health facilities. Strengthening infrastructure, streamlining diagnostic processes, and implementing awareness campaigns, especially for demographic groups with lower odds of early initiation, are recommended. Collaborative efforts between public and private sectors, along with ongoing monitoring and evaluation, are crucial for achieving the goals outlined in India's National Strategic Plan for TB Elimination by 2025. Addressing disparities in treatment initiation is fundamental to enhancing overall TB treatment efficacy and reducing the burden of the disease in the region.

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