Socio-Economic Impact of DOTS Strategy on Tuberculosis Control (A Case Study of Bhaktapur District)

Abstract

Background: The Directly Observed Treatment Short Course (DOTS) has considerable impacts on patients of tuberculosis in terms of knowledge, attitude and socio-economic condition. The study aimed to know the socio-economic impact of DOTS on tuberculosis patients. Methods: The study was conducted from September 2002-March 2003 at Bhaktapur district. In the study, 305 registered in 19 DOTS centers and sub-centers of Bhaktapur district from July 2002-February 2003 was set as universe. Among these 120 patients from nine different DOTS centers and sub-centers were considered for the study. A purposive sampling method was employed for the selection of respondents. Semi-structured interview, group discussion and key informant interview were performed to collect the primary information. Results: The most economically active (15-59 years) adults are under the high risk of tuberculosis. Expenditure for investigation, travel and nutritious diet was higher among the patients. The illness increased the expenditure (for medical treatment, transport and food) and loss of productivity which reduced the income. Loss of workdays was highest among the wage labours. The cost incurred seeking diagnosis in private hospitals is higher than that in government hospitals. However, DOTS decreased the period of work loss due to its strong follow up and regular drug consumption provision which ultimately helped the patients to recover their income. Conclusions: DOTS is available and accessible to all level of people and plays a significant role in reducing social stigma attached to the disease by caring the patient through regular supervision and observation. Keywords: directly observed treatment short course; impact; provision; socio-economic; strategy; tuberculosis.