Abstract
Background: Drug resistant-tuberculosis (DR-TB) patients are provided universal drug susceptibility testing (UDST), anti-TB drugs for the treatment of DR-TB, nutritional support (Nikshay Poshan Yojana - the financial incentive of rupees five hundred per month for each notified DR-TB patient for the duration for which the patient is on anti-TB drugs) by the Government of India.Methods: This retrospective cohort record-based study was conducted in DR-TB patients. Some 1095 DR-TB patients who have initiated treatment at Nodal DR-TB Centre, Darbhanga Medical College and Hospital (DMCH), Darbhanga, and continued their anti-TB drugs at home blocks were followed till their treatment outcome was known. Data were analyzed by statistical experts of DMCH.Results: Treatment supporters comprised 688 (62.83%) females and 407 (37.17%) males. Different types of treatment supporters noted were accredited social health activists (ASHAs) 622 (56.80%), family members 365 (33.33%), and community health workers 108 (09.86%). Treatment outcome as transfer out was observed in 08 (1.29%), 10 (2.74%), and 13 (12.03%) cases among ASHAs, family members, and community health workers, respectively [statistically significant (p < 0.0001)].Conclusion: ASHAs proved to be the best treatment supporters in comparison to both family members and community health workers for multi-drug resistant TB (MDR/RR-TB) patients.
Highlights
About half a million new cases of rifampicin resistant tuberculosis (RR-TB) occurred in 2019, out of which 78% had multi-drug resistant TB (MDR-TB)
At present the various Drug resistant-tuberculosis (DR-TB) treatment regimens used for the management of DR-TB cases are (a) shorter oral Bdq-containing MDR/RR-TB regimen: it consists of intensive phase (IP) of [(4-6) Bdq (6), levofloxacin (Lfx), clofazimine (Cfz), Z, E, H-h, ethionamide (Eto)] and continuation phase (CP) of [5 (Lfx, Cfz, Z, E)], total duration is of 9-11 months ; (b) longer oral M/XDR-TB regimen is of 18-20 months with no IP and CP, [1820 Lfx, Bdq, linezolid (Lzd), Cfz, cycloserine (Cs)]; (c) bedaquiline, pretomanid, and linezolid (BPaL) regimen [(6-9 months) BPaL] and (d) H mono/ poly DR-TB regimen [(six or nine months) Lfx, R, E, Z]
All MDR/RR-pulmonary TB patients, whose treatment was initiated at Nodal DR-TB Centre (NDR-TBC), Darbhanga Medical College & Hospital (DMCH), Laheriasarai, Darbhanga during the period from 1st September 2016 to 31st December 2020 and sent back through CDO (DTO) Darbhanga to their respective primary health centers (PHCs) in Darbhanga District were studied till their final treatment outcome was known
Summary
About half a million new cases of rifampicin resistant tuberculosis (RR-TB) occurred in 2019, out of which 78% had multi-drug resistant TB (MDR-TB). At present the various DR-TB treatment regimens used for the management of DR-TB cases are (a) shorter oral Bdq-containing MDR/RR-TB regimen: it consists of intensive phase (IP) of [(4-6) Bdq (6), levofloxacin (Lfx), clofazimine (Cfz), Z, E, H-h, ethionamide (Eto)] and continuation phase (CP) of [5 (Lfx, Cfz, Z, E)], total duration is of 9-11 months ; (b) longer oral M/XDR-TB regimen is of 18-20 months with no IP and CP, [1820 Lfx, Bdq (six months or longer), linezolid (Lzd), Cfz, cycloserine (Cs)]; (c) bedaquiline, pretomanid, and linezolid (BPaL) regimen [(6-9 months) BPaL] and (d) H mono/ poly DR-TB regimen [(six or nine months) Lfx, R, E, Z]. Drug resistant-tuberculosis (DR-TB) patients are provided universal drug susceptibility testing (UDST), anti-TB drugs for the treatment of DR-TB, nutritional support (Nikshay Poshan Yojana - the financial incentive of rupees five hundred per month for each notified DR-TB patient for the duration for which the patient is on anti-TB drugs) by the Government of India
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