1372. Patient’s Perceptions of Barriers to Tuberculosis Care in Private Sector in India

BACKGROUND: In spite of ambitious plans of all the stakeholders involved there is still a long way to go before Tuberculosis (TB) is eliminated In India due to barriers to care and cure. About half of the population affected with TB gets treated in the private sectors. This study was aimed to assess the patient knowledge on Tuberculosis and identify the barriers perceived by them. METHODS: A prospective study was conducted in a tertiary care center for a period of 3 months after obtaining approval from the Institutional ethics committee. All adults >18years diagnosed with tuberculosis (pulmonary, extrapulmonary) and receiving treatment in the Infectious Diseases Department were included. Subjects enrolled in the study were fully informed and gave their consent. A questionnaire was used to gather data regarding patient demographics, location, household size, co-morbid conditions, treatment, adverse drug reactions and barriers faced for their treatment. RESULTS: A total of 50 patients enrolled in the study. The majority of subjects belonged to age groups of 31–50 years (38%) with postgraduates accounting for 30%. About half (48%) of them were not working and 36 (72%) were married. About 31 (62%) were residing locally. The household size was 3–5 members (72%). Diabetes (13, 26%) and hypertension (11, 22%) were the common comorbid conditions seen. Newly diagnosed cases comprised of 35 (70%). Extrapulmonary TB was seen in 30 cases (60%) with lymph node and spine TB being more common. Adherence to the treatment was seen in 34(68%). Awareness regarding treatment duration and importance of treatment completion was seen in 64% and 82% of the study population, respectively. About 62% had visited more than one doctor for diagnosis with 42% responded that there was a delay in diagnosis. Common Barriers faced were stigma, adverse drug reactions, and transportation in 40 %, 12%, and 6% cases. The other factors faced by the respondents were the cost of diagnosis and treatment, adherence issues and loss of income. CONCLUSION: India has the world’s highest incidence of Tuberculosis. Multifaceted barriers worsen the burden of Tuberculosis. Private sectors treat the majority of the extrapulmonary disease. Intensified efforts by means of public awareness and education are required to prevent the delay in diagnosis and reducing stigma. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.