15.4.3  Tracing patients who interrupt treatment

If you cannot locate a ‘defaulter’ patient who has interrupted treatment at the home address recorded on the TB unit register form, try to find the patient through the contact person listed on the card. Seek information and leave messages with neighbours and relatives or at the patient’s workplace. Try to find out whether the patient is just temporarily missing or has permanently moved. If the patient has moved, try to find out the new location and notify the District TB Coordinator. In this way the patient may eventually be transferred to the care of another health facility.

If a patient is found and resumes treatment within a month, the same treatment should be continued and should be prolonged to make-up for the missed doses. If treatment is interrupted for between one and two months, the patient will need a new sputum examination before the appropriate treatment can be determined. If treatment is interrupted for two months or more, the patient has defaulted. The treatment outcome ‘default’ should be entered on the TB unit register form. If the patient returns, he or she will need to be re-assessed to determine the appropriate treatment.