Summary: Setting: Revised National Tuberculosis Control Programme emphasizing on DOTS in the urban set-up of Bangalore

Objective: 1) To identify socio-demographic and treatment related risk factors predictive of default with DOT 2) To study treatment regularity and final bacteriological profile of defaulted tuberculosis (TB) patients. Design: A retrospective case control analysis of the data obtained from the cohort study of 264 new (CAT I) and 219 retreatment (CAT II) bacteriological positive patients treated under DOTS from March 99 to September 2000 and followed up till treatment outcome. Data collection was through interviews at treatment initiation and at treatment outcome using pre-tested semi-structured interview schedules. Results: Defaults were 25 % and 45 % in CAT I & CAT II respectively. The predictive factors associated with default identified through multivariate logistic regression were male (Adjusted Odds Ratio (AOR) =2.49(1.10-6.18)-CAT I, 2.78(1.15-6.7)-Cat II) and alcoholism (AOR=6.38 (3.25-12.5)-CAT I, 3.93 (2.1-7.5)-Cat II). In addition, patients having poor knowledge of TB (AOR=3.06(1.24-7.54)-Cat II) and those returning for treatment after default (AOR=2.55(1.31-4.94)-Cat II) were predictors of default among re-treatment patients. Majority (CAT I =65.7%, CAT II =71%) of the patients defaulted in the Intensive Phase particularly after the 12th dose. More than half of the defaulted patients remained bacteriologically positive at the end of treatment period. Conclusion: The males and alcoholics are predictive risk factors of default with DOT in an urban setting. Those returning for treatment after default and having poor knowledge of disease are additional risk factors among re