Outcomes of directly observed treatment for drug resistant tuberculosis

Abstract

Introduction: Drug resistant – tuberculosis (DR-TB) is a man-made disorder & needs human care for cure i.e. directly observed treatment (DOT). We followed the WHO 1 recommended pragmatic approach for DR-TB cases in full 9letter & spirit9, i.e. by offering full duration of treatment to DR-TB cases as indoor patients thereby, observing them clinically, microbiologically, and radiologically Aim & Objectives: To assess the outcome of DOT for DR-TB Material & Methods: All DR-TB cases diagnosed from Jan 2012 - Dec 2015, using culture, nucleic acid amplification tests or line probe assays were subjected to treatment regimens as per updated WHO DR-TB guidelines 1. They were managed as indoor patients and were routinely evaluated clinically (daily), microbiologically (monthly smears & cultures in intensive phase & 3 monthly thereafter), radiographically (3 monthly) and hematologically &biochemically (monthly initially and 3 monthly or as & when required) till complete duration of therapy. Results: Of the 412 cases of Pulmonary TB managed from Jan 2012- Dec 2015, 81 (19.67%) cases had primary drug resistance, of which 04 (4.9%) were XDR-TB & 04(4.9%) were MDR-TB cases. Remaining (90.12%) TB cases were polydrug resistant TB. Two cases (2.47%) succumbed to illness and 02 (2.47%) continued to be sputum smear & culture positive despite DOT. The remaining 77 (95.06%) cases were declared cured and are being followed up post treatment Conclusion: Though man9s carelessness has created DR-TB, the study shows that human care by DOT can effectively cure DR-TB