scholarly journals Treatment outcome of new smear positive patients of pulmonary tuberculosis treated under directly observed treatment, short-course in a rural tertiary care hospital of a hilly area

Author(s):  
Aradhna Sharma ◽  
Dinesh Kansal ◽  
Kiran Katoch ◽  
Parveen Sharma ◽  
Rekha Bansal ◽  
...  
Author(s):  
Payal P. Naik ◽  
Arvindsingh Panwar ◽  
Swati Patel

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.


Author(s):  
Parigna R. Trivedi ◽  
Tejas M. Khakhkhar

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.


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