Identifying predictors of treatment outcome in Tuberculosis

Abstract

Background: Response to the treatment can be gauzed from the symptomatology, anthropometry, clinical parameters, and simple laboratory investigations in patients on anti-tuberculosis treatment as per Revised National Tuberculosis Control Programme (RNTCP) guidelines. Those who are not showing improvement in the parameters can then be selectively subjected to Cartridge Based Nucleic Acid Amplification Test and further intensive monitoring & follow-up. Materials and Methods:The project was undertaken in the one District of Maharashtra State from July 2017- to December 2018. The experts specifically identified parameters to be monitored in the field and specially trained Senior Treatment Supervisors workers (STS) followed up 100 newly diagnosed patients with Tuberculosis fortnightly during the Intensive Phase and monthly thereafter till completion of the 6-month treatment. Results: There was no significant difference in the patients according to age, sex, religion, education, occupation, and socio-economic status. The increase in weight, body mass index, chest circumference during inspiration and expiration, mid-arm circumference, and hemoglobin from the commencement of treatment to completion showed a significant positive correlation. A negative correlation was found with body temperature, pulse rate, respiratory rate, lymphocytic count, and Erythrocyte Sedimentation Rate. There was no correlation with the blood sugar level. Conclusion: This study has observed that objective parameters of gain in weight, reduction of fever, improvement in chest expansion, reduction in pulse and respiratory rate, respiratory rate are significantly associated with favorable outcome after a standard daily regimen under RNTCP. STS workers can easily monitor these parameters during their home visit.