Sputum conversion and defaulter rate in the directly observed therapy short course among new sputum positive cases in Tirupati, Andhra Pradesh

Background: The directly observed therapy short course (DOTS therapy) has achieved a case detection rate of 70% and cure rate of 85% in new sputum positive cases of tuberculosis. Despite this, a few patients still default from treatment. This study is an attempt to find the sputum conversion and defaulter rates among new sputum positive cases treated by tuberculosis center attached to a tertiary care hospital, Tirupati, Andhra Pradesh. Materials and Methods: This longitudinal observational study was conducted during the period from January to December, 2011 among 200 new sputum positive patients attending Revised National Tuberculosis Control Program unit. The patients were followed-up at their houses individually and necessary information collected. Sputum results after 2, 3 and 6 months were obtained from Tuberculosis Clinic Laboratory Register. Results: The sputum conversion rate was found to be 54.0% after 2 months and 85% at the end of treatment. The defaulter rate was found to be 15% with higher prevalence in relation to male sex (18.8%), 15-44 years (25.9%) and unskilled labor (23.9%). The main reasons for default were found to be travel (33.3%) and lack of motivation (26.7%). Conclusion: Even under DOTS therapy, the defaulter rate can be significantly high indicating the need for constant supervision.