Rao Nisar Ahmed, Anwer Tehzeeb, Saleem Muhammad
Department of Pulmonology, Ojha Institute of Chest Diseases, University Road, Karachi.
J Pak Med Assoc. 2009 Apr;59(4):223-5.
To assess the magnitude and reasons of initial default in pulmonary tuberculosis patients, diagnosed at Nazimabad Chest Clinic, Karachi.
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.
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'.
A high initial default for initiating Anti-Tuberculosis Therapy is a serious issue that needs to be addressed.
评估在卡拉奇纳齐马巴德胸科诊所确诊的肺结核患者初次违约的程度及原因。
这项前瞻性研究于2007年12月1日至2008年4月30日进行了五个月。疑似肺结核患者被要求进行三份痰涂片抗酸杆菌（AFB）检测。本研究纳入了未领取报告因此未开始抗结核治疗的涂片阳性患者。通过电话联系这些患者，询问违约原因，并为他们提供免费治疗。
在研究期间，869名疑似肺结核患者中，224人被诊断为涂片阳性肺结核。在这224人中，162人自行登记接受治疗。其余62/224（27.67%）为初次违约者。通过电话联系，55人（88.70%）可追踪，而7/62（11.29%）为无法追踪的违约者。24名患者（38.70%）到诊所报到并登记接受治疗。最常见的违约原因是“对诊所服务不满意”。
抗结核治疗初始阶段的高违约率是一个需要解决的严重问题。
