Global Journal of Medical Research, K: Interdisciplinary, Volume 22 Issue 4

Table-2: Distribution of the study population according to the registration status Registration status Area of referral Total Inside district Outside district Registered 224 439 663 Not registered 33 62 95 Total 257 501 758 degree of freedom=1). Thus, though there is no significant urban-rural divide in case of registration at the DOTS centres, the relevant authorities should urgently devise ways to urge all the referred patients to register at the DOTS centres; otherwise the problem of TB cannot be handled efficiently. Table-3 displays how many of the referred patients were newly infected with TB, and how many were infected with TB before, but had come for treatment again, as the previous treatment was unsuccessful. Table-3: Distribution of the study population according to disease status Area of referral Disease status Total New case Retreatment case Inside district 204 53 257 Outside district 435 66 501 Total 639 119 758 It is clear from table-3 that quite a large number of patients (119 among 758 i.e., nearly 16%) had come for retreatment due to inadequacy of previous treatment method. This is really a cause of concern. Also, this fact indicates the shortcomings of the ‘referral for treatment’ system going on since 2003. Further, the chi-square test shows that the association between the area of referral and the disease status is significant at 5% level (p- value=0.00738<0.05; degree of freedom=1). It shows that there is a significant urban-rural divide with respect to the adequacy/success of previous TB treatment Table-4 depicts how many of the new sputum positive TB patients (who registered in the DOTS centres after referral) were converted into sputum negative patients after 2-3 months of treatment. Table-4: Distribution of the new sputum positive registered patients according to conversion status Area of referral Conversion status Conversion of new sputum +ve cases after 2-3 months (A) No conversion of new sputum +ve cases after 2-3 months Total new sputum +ve cases (B) Conversion rate (%) [AX100/B] Inside district 60 34 94 64 Outside district 78 28 106 74 Total 138 62 200 69 23 Year 2022 Global Journal of Medical Research Volume XXII Issue IV Version I ( D ) K © 2022 Global Journals Evaluation of ‘Referral for Treatment’ System under RNTCP in a Hospital at Kolkata, India It can be seen from table-2 that a considerable number of patients (95 among 758 i.e., nearly 13%) did not register in the DOTS centre for treatment after referral; this is a cause of worry. Also, it may be noted that the number of non-registered patients at DOTS centres located outside district (i.e., outside the metropolis of Kolkata) is nearly double that for DOTS centres located inside district (i.e., within Kolkata). However, the chi-square test shows that the association between the area of referral and the registration status is not significant at 5% level (p-value=0.85286>0.05; technique. The pertinent authorities should see that new TB patients get adequate treatment so that, in future, there will be no need for retreating previously treated TB patients. Also, they should ascertain that there is no urban-rural divide with regard to adequacy of TB treatment.