Re-treatment outcome of smear positive tuberculosis cases under DOTS in Bangalore city

Vijay, Sophia; Balasangameshwara, V.H.; Jagannatha, P.S.; Saroja, V.N.; Shivashankar, D. and Jagota, P. (2002) Re-treatment outcome of smear positive tuberculosis cases under DOTS in Bangalore city. Indian Journal of Tuberculosis, 49. pp. 195-204.

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Abstract

A cohort of 226 smear and culture positive re-treatment cases, initiated on Cat II regimen under DOTS, was followed up prospectively from April 1999 to September 2001, in Bangalore Mahanagara Palike to study the treatment outcome along with the drug susceptibility status. The cohort was interviewed at the initiation and end of treatment using a pre-tested semi-structured questionnaire to elicit details regarding past and present treatment. More than half of the study group (60%) were initially susceptible to all the regimen drugs. MDR -TB among the cohort was 12.8%. ’Treatment after default’ cases constituted bulk of the cohort (65.5%) and ’defaults’ among them were high. The overall favorable re-treatment outcome in the cohort was only 39.8% as a result of a high proportion of ’defaults’ (43.8%). However, favorable outcome among those completing the prescribed duration of treatment was 75%, irrespective of pre-treatment drug susceptibility status. In addition, emergence of drug resistance, especially to Rifampicin, was negligible (1.8%) during current treatment despite the high default rate suggesting effectiveness of Cat II regimen. Favorable response among pre-treatment MDR cases was low (17.2%), and remained so even after excluding defaults, (22.7%) because the MDR component of the cohort was small. The study underscores the importance of treatment adherence for achieving success. The focus of treating the cohort should have been on prompt defaulter retrieval, especially of patients belonging initially to this type "treatment after default", who were potential defaulters. Besides, the low treatment efficiency in MDR cases makes it prudent to prevent development of MDR during primary treatment by strict adherence to DOTS, thereby making failed cases more amenable for re-treatment with Cut II regimen.

EPrint Type:Article
Additional Information:Paper presented at the 56th National Conference on Tuberculosis and Chest Diseases, Chennai, October 9-12, 2001.
Uncontrolled Keywords:Re-treatment, Pulmonary TB, Cat II regimen, Drug Resistance, Treatment outcome, DOTS, Bangalore
Subjects:Therapeutics > Drug Therapy
Chemical and Pharmacologic Phenomena > Drug Resistance
Diagnosis > Prognosis
-Institutional Repositories > National Tuberculosis Institute
Respiratory Tract Diseases > Respiratory Tract Infections > Tuberculosis, Pulmonary
Investigative Techniques > Drug Administration Schedule
Respiratory Tract Diseases > Lung Diseases > Tuberculosis, Pulmonary
-Journal Repositories > Indian Journal of Tuberculosis
ID Code:645
Deposited By:Librarian Sudha S Murthy
Deposited On:09 August 2005

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