scholarly journals Treatment outcome of tuberculosis patients under directly observed treatment short-course and factors affecting the outcome in tertiary care hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 981 ◽  
Author(s):  
Parigna R. Trivedi ◽  
Tejas M. Khakhkhar
Keyword(s):  
Treatment Outcome ◽  
Tertiary Care ◽  
Control Programme ◽  
High Rate ◽  
Care Hospital ◽  
Factors Affecting ◽  
Institutional Ethics ◽  
Short Course ◽  
Directly Observed Treatment

Background: Revised National Tuberculosis Control Programme (RNTCP) based on Directly Observed Treatment Short-course (DOTS) strategy has been made available in entire country by March 2006. Given high rate of unfavourable treatment outcomes reported in some provinces, there is a need to analyse outcomes and identify possible trends and associated risk factors that can help for improvement in RNTCP.Methods: After getting Institutional Ethics Committee (IEC) approval, total of 76 cases diagnosed and treated for Tuberculosis (TB) under Category I of RNTCP were recruited from January to March 2017. All patients were followed up for six months from date of initiating the treatment. The data was obtained from TB treatment register, by patient visit and regular follow-up. The information collected include age and gender of patient, category of treatment, date of treatment initiation, initial sputum conversion, outcome of treatment and date of outcome.Results: Out of total 76 patients, 64 (84.21%) were cured, 5 (6.57%) were lost to follow-up, 4 (5.26%) were failed to treat, 1 (1.32%) patient was died, 1 (1.32%) patient had completed treatment but status was unknown and 1 (1.32%) patient was not evaluated because of transfer. Overall treatment outcome of TB patients under DOTS was matching goal of RNTCP with cure rate of 84.21%.Conclusions: Efforts by DOT providers, adequate patient education, motivating ones in need can bring positive outcomes. In this region, DOTS center is at good working condition in terms of functionality as well as ethically. Gender, age group, residence and initial culture colony did not significantly affect treatment outcome.

scholarly journals Paediatric Tuberculosis at the Directly Observed Treatment Short-Course Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

2020 ◽  
pp. 32-38
Author(s):  
B. I. Garba ◽  
T. Yusuf ◽  
L. K. Coker ◽  
K. O. Isezuo ◽  
M. O. Ugege ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Relevant Information ◽  
University Teaching ◽  
First Line ◽  
Successful Treatment Outcome ◽  
Short Course ◽  
Directly Observed Treatment ◽  
Lost To Follow Up ◽  
Paediatric Tuberculosis

Introduction: Tuberculosis (TB) is the leading infectious disease killer worldwide, despite significant progress against the disease in recent years. Most cases of TB in children occur in the TB endemic countries but the actual burden of paediatric TB is unknown. With early diagnosis and treatment using the first-line anti-tuberculous drugs, most people who develop the disease can be cured and onward transmission of infection curtailed. Objective: To determine the pattern and outcome of paediatric tuberculosis managed at a tertiary facility in Sokoto, Nigeria. Materials and Methods: Records of children managed for TB at the Directly observed treatment short-course (DOTS) clinic over a three-and-a-half-year period were reviewed retrospectively. All children (≤ 15 years) treated for TB over the study period was included. Relevant information was retrieved from the register and analysed accordingly. Results: 74 children were treated with 33(44.6%) being males, giving a M: F ratio of 1:1.2. Mean (±SD) age was 85.78 (±55.40) months and 34 (45.9%) belonged to the 0.0-5.0-year age group. Seventy-one (95.9%) were new cases and three (4.1%) were relapse. Pulmonary TB (PTB) was seen in 50 (67.6%), more females had PTB than males, which was not significant (χ2=0.4, p=0.52). Acid fast bacilli (AFB) were positive in only 8 (10.8%) while GeneXpert MTB/RIF sensitivity was detected in 7 (9.2%). Majority 36 (48.6%) were lost to follow up, 30 (40.5%) completed treatment, only 4(5.4%) were cured with no recorded mortality. Successful treatment outcome was low (45.9%). Conclusion: Treatment outcome using DOTS strategy was poor, far below the WHO benchmark. There is need to improve adherence to DOTs therapy to prevent development of multi drug resistant TB. 

scholarly journals A study on non-compliance in tuberculosis cases towards the directly observed treatment short course under RNTCP in Kanpur Nagar

2017 ◽  
Vol 4 (12) ◽  
pp. 4485 ◽  
Author(s):  
Kuldeep Srivastava ◽  
Abhishek Gupta ◽  
Ruchi Saxena ◽  
R. P. Sharma ◽  
Tanu Midha
Keyword(s):  
Symptomatic Relief ◽  
Compliance Rate ◽  
Treatment Compliance ◽  
Sampling Technique ◽  
Control Programme ◽  
High Rate ◽  
Class Iii ◽  
Skilled Workers ◽  
Short Course ◽  
Directly Observed Treatment

Background: The goal of Revised National Tuberculosis Control Programme (RNTCP) is to achieve cure rate of at least 85% and to detect at least 70% of the new smear positive cases of tuberculosis (TB). A very high rate of compliance to treatment is required to achieve the target and to prevent the drug resistance. The objective of the study was to study the magnitude and reasons of non-compliance in TB patients towards directly observed treatment short course (DOTS) in Kanpur Nagar.Methods: Multistage random sampling technique was used to select the study subjects from the two designated microscopy centres (DMC). Information regarding treatment compliance and patient satisfaction was elicited and recorded in the predesigned and pretested questionnaire, analysis was done using SPSS and  percentages was used to draw the results.Results: Out of total 300 study subjects, 41(13.67%) were non-compliant during treatment. Majority of non-compliant study subjects were aged more than 50 years (30.23%), skilled workers (29%), belonged to socioeconomic class III (22.9%), Muslims (19.36%) and educated upto high school (16.33%). The most common cause of non-compliance in the present study was symptomatic relief during treatment (73.20%) followed by intolerance to medications (24.40%).Conclusions: Compliance to the drug regimen under RNTCP plays a vital role in the cure of the TB cases. Non-Compliance rate being high in the present study, health education of the community at large and regular follow up of all defaulters, to find out the reasons for default and measures to reduce them, requires more emphasis to achieve the goal of RNTCP. 

scholarly journals The study of adverse drug reactions in indoor patients of tuberculosis taking standardized antitubercular therapy (directly observed treatment short-course and programmatic management of drug resistant tuberculosis) in a tertiary care hospital at Surat

2021 ◽  
Vol 10 (5) ◽  
pp. 507
Author(s):  
Payal P. Naik ◽  
Arvindsingh Panwar ◽  
Swati Patel
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Short Course ◽  
Directly Observed Treatment

Background: Tuberculosis is a serious public health issue in India. The treatment regimen followed is Directly observed treatment short-course (DOTS) and Programmatic Management of Drug resistant Tuberculosis (PMDT) approach. In a long period of treatment adverse drug reactions (ADRs) can be an important programmatic issue. Thus, study was undertaken to assess the ADRs caused by antitubercular therapy in indoor patients in a tertiary care hospital at Surat.Methods: The Observational, prospective study was carried out for one year period. The causality was determined by WHO UMC scale and severity was determined by Modified Hartwig and Siegel scale. Chi square test was applied for statistical analysis.Results: Among 255 tuberculosis patients, 85 (33.3%) patients developed ADRs. Occurrence of ADRs was more among females (46.6%). The commonly involved systems are gastrointestinal (40.6%) followed by haematological (17.9%). The most common ADRs observed were nausea and vomiting (21.7%). High percentage of ADRs causing drugs were isoniazid (30.6%) followed by rifampicin (26.1%). Causality assessment showed 60.4% ADRs were possible, 37.7% ADRs were probable and 1.9% ADRs was certain. Severity assessment scale showed 81.1% of moderate, 12.3% of mild and 6.6% of severe grading. Occurrence of ADRs was more among PMDT (60%) in comparison to DOTS therapy (31.06%) [p value = 0.0084 (significant p value < 0.05)].Conclusions: Antitubercular treatment is safer but early detection, management and reporting of ADRs is required to prevent it at initial stage and helps to decrease default rate.

scholarly journals Tuberculosis in elderly: The Indian perspective

2018 ◽  
Vol 5 (4) ◽  
pp. 983
Author(s):  
Nehal . ◽  
Supriya Tiwari ◽  
Shyamala Krishnaswamy Kothandapani ◽  
Usha . ◽  
Khena .
Keyword(s):  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Cross Sectional ◽  
Loss To Follow Up ◽  
Adherence To Medication ◽  
Study Population

Background: Tuberculosis, the leading infectious cause of morbidity, mortality worldwide. Elderly Tuberculosis accounts for a major proportion of these cases and are often neglected due to associated comorbidities and overlapping clinical features. This study aimed to estimate the prevalence of tuberculosis among elderly and medication adherence.Methods: A cross-sectional, retrospective study in patients with Tuberculosis ≥50 years registered under RNTCP, at a tertiary care hospital, South India, from January 2017 to December 2017. Clinical data collected, and medication adherence was assessed.Results: Out of the total 187 study population, 35 subjects were found to be ≥50 years with a prevalence of 18.7%. Pulmonary Tuberculosis was more common (82.8%). Majority of the subjects were sputum positive (77.14%). Comorbidities highest in patients >70years. Diabetes was the most significant comorbidity in all the age groups (48.57%) and patients with pulmonary Tuberculosis (p=0.04). Pulmonary Tuberculosis observed highest among smokers whereas extra pulmonary Tuberculosis found higher among alcoholics (33.3%). Treatment outcome was better in patients with hypertension compared to other comorbidities (p=0.014). Loss to follow-up was highest among smokers and in patients with bronchial asthma (40%). Present study showed moderate to low adherence to medication in elderly.Conclusions: There is high prevalence of Tuberculosis among elderly. Diabetes was the commonest comorbidity. Pulmonary Tuberculosis was significantly associated with smokers. Low adherence and loss to follow-up was high among elderly. We recommend comprehensive screening, treatment and follow-up especially in elderly with comorbidities for early diagnosis and better treatment outcome.  

scholarly journals Efficacy and Safety of Diphenylcyclopropenone in the Treatment of Multiple Warts - A Prospective Study at a Tertiary Care Hospital, Mumbai

2021 ◽  
Vol 8 (20) ◽  
pp. 1580-1585
Author(s):  
Prathyusha Yakkala ◽  
Rachita Dhurat ◽  
Meghana Phiske
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
Viral Origin ◽  
Factors Affecting ◽  
Type Iv ◽  
Significant Difference ◽  
A Prospective Study

BACKGROUND Diphenylcyclopropenone (DPCP) produces type IV hypersensitivity reaction, immune response being directed against a complex of contact agent hapten bound to proteins of viral origin that enhance wart regression. We wanted to evaluate the efficacy and safety of DPCP in multiple warts along with the various factors affecting DPCP response METHODS A prospective study with 49 patients older than 5 years with 5 or more warts in any area (except genital) was conducted. Patients were sensitized with 2 % DPCP solution and examined after 48 hours. Sensitization was graded as mild, moderate, severe or no sensitization. Patients with mild / moderate sensitization were further applied DPCP; patients with severe sensitization were included after subsidence of reaction and patients with no sensitization were excluded. After sensitization, weekly applications were made on warts. Concentration causing mild reaction was selected as optimal and was applied till lesion clearance. Follow up was for 3 months for recurrences. Response was graded as complete, partial and no response. RESULTS Males outnumbered females. Mean age was 23 years. Mean duration was 12 months. Recurrent and resistant warts were seen in 15 and 6 patients respectively. Mean number of warts was 15.6. 49 patients were tested for sensitization, 1 failed sensitization and 48 were continued with weekly DPCP. 2 developed distant eczematisation and 4 were lost to follow up. Out of 42, complete clearance was seen in 35 (83.3 %), partial in 3 (7.14 %) and no response in 4 (9.52 %). Local eczematisation, lymphadenopathy, hyperpigmentation were the side effects. Response was better with increasing age. Warts less than 6 months had 100 % response. There was no statistically significant difference between site and type of warts and response to DPCP, recurrent and untreated warts in terms of response and response to sensitization and final response. CONCLUSIONS DPCP is an excellent option for multiple / resistant warts with good safety profile. KEYWORDS Diphenylcyclopropenone, Multiple Warts, Safety, Efficacy, Various Factors Affecting Response

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