Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study
Introduction: Multi Drug Resistant Tuberculosis (MDR TB) has emerged as a significant public health problem in India. The prolonged treatment duration in MDR TB is a challenge in achieving treatment completion and poses a threat to TB control in the country. Home based care is an approach accept...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2017-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/10401/27594_CE(RA1)_F(T)_PF1(NE_VT_SS)_PFA(NE_SS).pdf |
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| author | Neha Taneja Vinoth Gnana Chellaiyan Shailaja Daral Mrinmoy Adhikary Timiresh Kumar Das |
| author_facet | Neha Taneja Vinoth Gnana Chellaiyan Shailaja Daral Mrinmoy Adhikary Timiresh Kumar Das |
| author_sort | Neha Taneja |
| collection | DOAJ |
| description | Introduction: Multi Drug Resistant Tuberculosis (MDR TB)
has emerged as a significant public health problem in India.
The prolonged treatment duration in MDR TB is a challenge in
achieving treatment completion and poses a threat to TB control
in the country. Home based care is an approach accepted by
patients because it helps in ameliorating their understanding
of TB, improving the compliance and reducing stigma in the
community.
Aim: To assess the outcome of Home-Based Care (HC) versus
No Home-Based Care (NHC) on the treatment of MDR TB
patients registered at two chest clinics in Eastern Delhi.
Materials and Methods: A quasi-experimental study was
done among diagnosed MDR TB patients receiving Category
IV regimen under Revised National Tuberculosis Control
Programme (RNTCP) from two government chest clinics in
Eastern Delhi during May 2014 to May 2016. In the control arm,
50 MDR TB patients at one of the chest clinics were offered
the standard Category IV regimen under RNTCP; while in the
intervention arm, 50 MDR TB patients at the second chest
clinic were provided home based care (counselling, support for
completion of treatment, rehabilitation, and nutritional support)
along with the standard treatment. The primary outcome
assessed was outcome of treatment, while secondary outcomes
included stigma faced due to the disease, and impact of disease
on family and community life.
Results: The primary outcome data was available for 32 (64%)
participants in the intervention arm, and 38 (76%) participants in
control arm. The treatment was significantly more successful in
the intervention arm (p<0.03). The data on secondary outcomes
was available for all participants. Stigma due to disease was
significantly lower in the intervention arm (p<0.01); also rejection
faced by participants from family and community due to disease
was significantly lower among the HC group (p<0.05).
Conclusion: Home-based care in MDR TB treatment holds
potential in improving treatment outcomes of patient. |
| first_indexed | 2024-12-12T23:43:50Z |
| format | Article |
| id | doaj.art-d31c632881ca4869bd511b920a2acd23 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-12T23:43:50Z |
| publishDate | 2017-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-d31c632881ca4869bd511b920a2acd232022-12-22T00:07:01ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-08-01118LC05LC0810.7860/JCDR/2017/27594.10401Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot StudyNeha Taneja0Vinoth Gnana Chellaiyan1Shailaja Daral2Mrinmoy Adhikary3Timiresh Kumar Das4Senior Resident, Department of Community Medicine, NDMC Medical College and Hindu Rao Hospital, Delhi, India.Assistant Professor, Department of Community Medicine, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.Senior Resident, Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India.Assistant Professor, Department of Community Medicine, Murshidabad Medical College and Hospital, Murshidabad, West Bengal, India.Senior Resident, Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India.Introduction: Multi Drug Resistant Tuberculosis (MDR TB) has emerged as a significant public health problem in India. The prolonged treatment duration in MDR TB is a challenge in achieving treatment completion and poses a threat to TB control in the country. Home based care is an approach accepted by patients because it helps in ameliorating their understanding of TB, improving the compliance and reducing stigma in the community. Aim: To assess the outcome of Home-Based Care (HC) versus No Home-Based Care (NHC) on the treatment of MDR TB patients registered at two chest clinics in Eastern Delhi. Materials and Methods: A quasi-experimental study was done among diagnosed MDR TB patients receiving Category IV regimen under Revised National Tuberculosis Control Programme (RNTCP) from two government chest clinics in Eastern Delhi during May 2014 to May 2016. In the control arm, 50 MDR TB patients at one of the chest clinics were offered the standard Category IV regimen under RNTCP; while in the intervention arm, 50 MDR TB patients at the second chest clinic were provided home based care (counselling, support for completion of treatment, rehabilitation, and nutritional support) along with the standard treatment. The primary outcome assessed was outcome of treatment, while secondary outcomes included stigma faced due to the disease, and impact of disease on family and community life. Results: The primary outcome data was available for 32 (64%) participants in the intervention arm, and 38 (76%) participants in control arm. The treatment was significantly more successful in the intervention arm (p<0.03). The data on secondary outcomes was available for all participants. Stigma due to disease was significantly lower in the intervention arm (p<0.01); also rejection faced by participants from family and community due to disease was significantly lower among the HC group (p<0.05). Conclusion: Home-based care in MDR TB treatment holds potential in improving treatment outcomes of patient.https://jcdr.net/articles/PDF/10401/27594_CE(RA1)_F(T)_PF1(NE_VT_SS)_PFA(NE_SS).pdfdomiciliary caremultidrug resistant tuberculosisstigma |
| spellingShingle | Neha Taneja Vinoth Gnana Chellaiyan Shailaja Daral Mrinmoy Adhikary Timiresh Kumar Das Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study Journal of Clinical and Diagnostic Research domiciliary care multidrug resistant tuberculosis stigma |
| title | Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study |
| title_full | Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study |
| title_fullStr | Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study |
| title_full_unstemmed | Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study |
| title_short | Home Based Care as an Approach to Improve the Efficiency of treatment for MDR Tuberculosis: A Quasi-Experimental Pilot Study |
| title_sort | home based care as an approach to improve the efficiency of treatment for mdr tuberculosis a quasi experimental pilot study |
| topic | domiciliary care multidrug resistant tuberculosis stigma |
| url | https://jcdr.net/articles/PDF/10401/27594_CE(RA1)_F(T)_PF1(NE_VT_SS)_PFA(NE_SS).pdf |
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