Newly-diagnosed Pulmonary Tuberculosis Research Articles

Chronic pulmonary aspergillosis incidence in newly detected pulmonary tuberculosis cases during follow-up.

Chronic pulmonary aspergillosis (CPA) is known to complicate patients with post-tubercular lung disease. However, some evidence suggests that CPA might co-exist in patients with newly-diagnosed pulmonary tuberculosis (P.TB) at diagnosis and also develop during therapy. The objective of this study was to confirm the presence of CPA in newly diagnosed P.TB at baseline and at the end-of-TB-therapy. This prospective longitudinal study included newly diagnosed P.TB patients, followed up at third month and end-of-TB-therapy with symptom assessment, anti-Aspergillus IgG antibody and imaging of chest for diagnosing CPA. We recruited 255 patients at baseline out of which 158 (62%) completed their follow-up. Anti-Aspergillus IgG was positive in 11.1% at baseline and 27.8% at end-of-TB-therapy. Overall, proven CPA was diagnosed in 7% at baseline and 14.5% at the end-of-TB-therapy. Around 6% patients had evidence of aspergilloma in CT chest at the end-of-TB-therapy. CPA can be present in newly diagnosed P.TB patients at diagnosis and also develop during anti-tubercular treatment. Patients with persistent symptoms or developing new symptoms during treatment for P.TB should be evaluated for CPA. Whether patients with concomitant P.TB and CPA, while receiving antitubercular therapy, need additional antifungal therapy, needs to be evaluated in future studies.

Risks of recurrence in people with pulmonary tuberculosis

OBJECTIVE. To assess the risk of relapse in patients with pulmonary tuberculosis (PTB).
 MATERIALS AND METHODS. 569 people with relapsed PTB (RPTB) were selected from the TB register (e-TB manager programme): 300 with a first case treatment outcome of “completed treatment” and 269 “cured”. The groups were compared according to the course and outcome of treatment of RPTB, clinical characteristics of the first case, medical and social risk factors, and all patients with RPTB were compared with the group of newly diagnosed PTB (NDPTB). Mathematical and conventional statistical methods were used to analyse.
 RESULTS AND DISCUSSIONS. It was found that patients with RPTB are a difficult group because more than 1⁄2 of them have lung destruction, 3⁄4 isolate mycobacterium tuberculosis (MBT), and more than 1⁄2 have resistance to antimycobacterial drugs (AMBD). In 73.6 % of them, medical and social risk factors were noted that may have caused or contributed to TB relapse and negatively affected the results of treatment. These factors include: severe comorbidities in 53.7 %, alcohol and drug abuse in 34.9 %, HIV infection in 30.5 %, and others (homelessness, release from prison, contact with a TB patient, unemployment, smoking, etc.); 62.1 % of patients had ≥2 risk factors at the same time.
 We consider the effectiveness of treatment of this category of patients to be insufficient, as the outcome of the main course of treatment was unsatisfactory in more than half of them (48.5 % of unsuccessfully treated, 4.7 % interrupted treatment, 8.3 % died), and taking into account repeated courses, the rate of effective treatment in some of them was only 65.6 %.
 There was no significant difference (neither in clinical characteristics nor in medical and social risk factors) between the groups of patients “cured” or “completed treatment” as a result of treatment of the first case of TB, but it was found that only 23.2 % of patients with RPTB were found to be resistant to AMBD at the first case of the disease, and 50.0 % of them had it, with multidrug resistance (MDR) in half of them.
 It has been statistically proven that patients with RPTB are more likely to have the following symptoms than patients with NDPTB: lung destruction (43.2±3.2 vs. 20.4±4.0 %, p<0.05), sputum isolation of MBT (38.1±3.3 vs. 24.9±3.9 %, p<0.05), multi- and poly-resistance of MBT to AMBD (30.2±8.1 vs. 9.5±4.3 %, p<0.05), various medical and social risks (73.6±2.2 vs. 44.5±3.4 %, p<0.05), including alcohol abuse (21.3±3.7 vs. 8.7±4.3 %, p<0.05 %), unemployment (51.1±2.9 vs. 21.9±4.0 %, p<0.05), concomitant diseases (39.5±3.3 vs. 8.5±4.3 %, p<0.05), HIV infection (22.5±4.0 vs. 4.9±4.4 %, p<0.05) and others – lack of a fixed place of residence, release from prison, contact with a TB patient, lack of permanent employment, smoking, etc. (64.3±2.5 vs. 8.3±4.3 %, p<0.05), as well as ≥2 risk factors at the same time (45.7±3.1 vs. 20.0±4.0 %, p<0.05), which confirms the role of the above factors as probable risks of relapse in TB patients.
 CONCLUSIONS. Since the role of unfavourable NDPTB course, medical and social risk factors such as unemployment, severe comorbidities, alcohol abuse, HIV infection and some others (belonging to persons of no fixed abode, release from prison, contact with a TB patient) as possible causes of the development (or contributing to) RPTB, which subsequently negatively affect treatment outcomes, patients with these factors should be considered a particularly dangerous population for the development of PTB and, accordingly, should be screened and monitored for life in risk groups accordingly.
 Given that the detection of MDR-TB in the first case of PTB is the most dangerous risk factor for RPTB, it is necessary to introduce the determination of MDR-TB resistance in all patients with NDPTB and, despite the results of their treatment, to follow up such persons in risk groups.
 Late detection of RPTB (in 3⁄4) indicates organisational shortcomings of primary care in TB control, primarily in the formation of risk groups and work with them, and requires the implementation of preventive measures taking into account the new realities and challenges of wartime.

THE EFFECT OF ANTIOXIDANT THERAPY ON THE CHANGES OF CLINICAL AND LABORATORY PARAMETERS IN ALCOHOL DRINKERS WITH PULMONARY TUBERCULOSIS

Objective. Determination of the effect of antioxidants on clinical and laboratory parameters in alcohol drinkers with infiltrative newly-diagnosed pulmonary tuberculosis (PTB). Materials and Methods. 109 patients with newly-diagnosed PTB were examined. All patients underwent a comprehensive medical examination, immunological blood tests, determination of the parameters of the oxidative stress-antioxidant defense system. Patients were divided into three main groups, depending on the level of alcohol consumption. Patients in each of the three groups were further divided into two subgroups depending on the treatment regimen. Statistical analysis was performed using the STATISTICA program. Results. In patients who received standard therapy, increased alcohol consumption was associated with a decrease in the positive changes of the majority of inflammation and immune status indicators. This trend, in particular, was observed with regard to the progress of the decay cavities closure, persistence of cough complaints, changes in indicators of the immune-inflammatory (CRP, CD8+, CD4/CD8, PAMW, IPC) and oxidative status (SOD, GPX) (p ≤ 0.05). After the antioxidants had been added, the best improvement of immune-inflammatory and oxidative status was observed in group 2 (p ≤ 0.05). Additional antioxidant therapy in patients with newly-diagnosed PTB, regardless of alcohol consumption, contributed to better positive dynamics of cellular immunity, oxidative stress, and endogenous intoxication. Conclusions. The addition of antioxidant drugs to the standard therapy of patients with newly-diagnosed PTB was accompanied by improved clinical and radiological, oxidative and immune-inflammatory parameters. Antioxidant therapy in such patients, regardless of the initial level of alcohol consumption, promoted better positive dynamics of phagocytic and enzymatic activity of neutrophils, oxidative stress, and endogenous intoxication. The best changes in immune-inflammatory and oxidative status among patients taking antioxidants were observed in those who took alcohol at a health-threatening level.

Dynamics of Clinical, Radiological and Laboratory Parameters in Patients with an Infiltrative Form of Firstly Diagnosed Pulmonary Tuberculosis

According to the World Health Organization, each year 10 million people are diagnosed with tuberculosis for the first time and 1.5 million people die from it. The death rate from this disease has increased in the world for the first time in more than ten years. Unfortunately, Ukraine is in the TOP-10 countries with the largest number of tuberculosis cases among population. Only in December 2021, 1,229 cases of tuberculosis were registered in Ukraine. To date, the course of the tuberculosis process has undergone significant changes. The infiltrative form (IF) of pulmonary tuberculosis accounts for the majority of new cases. Standardized treatment (60 doses in the intensive phase and 120 doses in the continuation phase) is not always sufficient for effective recovery and requires prolongation. That is why it is necessary to study the predictors that maximally reflect the need in therapy prolongation. The objective: to analyze the dynamics of clinical, laboratory and radiological parameters in patients with IF of newly diagnosed pulmonary tuberculosis (NDPT) under conditions of varying treatment effectiveness. Materials and methods. 120 men of working age with IF NDPT were examined in KNP of the Kharkiv Regional Council “Regional TB Dispancer N1” during 2019–2021. Patients were divided into two groups: Group 1 (n=89) included patients with positive clinical and radiological dynamics of the tuberculosis process, and as a result of treatment clearing of Mycobacterium tuberculosis (MBT) from the sputum; Group 2 included patients (n=31) with weak positive dynamics, as a result of which IF was extended to 90 doses. Comparison of clinical, laboratory and radiological data at the beginning and end of IF treatment in patients with different therapy efficiency was performed. The study was conducted in accordance with the requirements of good clinical practice, the Declaration of Helsinki of the World Medical Association, and was approved by the local ethic committee of the Kharkiv Medical Academy of Postgraduate Education. Results. An analysis of the dynamics of clinical, radiological and laboratory data showed that the decrease of immuno-inflammatory indicators levels (C-reactive protein, IL-4, IL-10, circulating immune complexes; CD4/CD8 ratio) was more pronounced in the group of patients who did not need treatment prolongation. At the same time this group was also characterized by significant increase in the level of IFN-γ by the end of the IF treatment, which could indicate activation of cellular immunity together with decrease in the levels of IL-4 and IL-10 which indicated the suppression of humoral immunity. Due to the predominance of cellular immunity over humoral, macrophage activation and their phagocytic activity were accelerated, as a result of which the process of MBT elimination was much faster and more efficient in Group 1 patients. Changes in cytokine levels were observed in patients of Group 1, who showed positive dynamics after IF treatment, but not in patients of Group 2, who demonstrated signs of cytokine dysregulation due to continuing specific inflammatory process. Conclusions. Tuberculosis remains one of the global health problems. The general trend in the spread of tuberculosis and mortality from it throughout the world requires urgent efforts to the detection and treatment of this disease. In patients with IF pulmonary TB standard treatment was less effective in case of slow insufficient decrease in the levels of CRP, IL-10, γ-INF, and the CD4/CD8 ratio which was associated with slow cavities healing, continuing spreading of the infiltrative process. These patients needed prolonged treatment regimen.

Therapeutic drug monitoring of rifampicin, isoniazid, and pyrazinamide in newly-diagnosed pulmonary tuberculosis outpatients in Denpasar area

Therapeutic drug monitoring of rifampicin, isoniazid, and pyrazinamide in newly-diagnosed pulmonary tuberculosis outpatients in Denpasar area

Accuracy of diabetes screening methods used for people with tuberculosis, Indonesia, Peru, Romania, South Africa.

ObjectiveTo evaluate the performance of diagnostic tools for diabetes mellitus, including laboratory methods and clinical risk scores, in newly-diagnosed pulmonary tuberculosis patients from four middle-income countries.MethodsIn a multicentre, prospective study, we recruited 2185 patients with pulmonary tuberculosis from sites in Indonesia, Peru, Romania and South Africa from January 2014 to September 2016. Using laboratory-measured glycated haemoglobin (HbA1c) as the gold standard, we measured the diagnostic accuracy of random plasma glucose, point-of-care HbA1c, fasting blood glucose, urine dipstick, published and newly derived diabetes mellitus risk scores and anthropometric measurements. We also analysed combinations of tests, including a two-step test using point-of-care HbA1cwhen initial random plasma glucose was ≥ 6.1 mmol/L.FindingsThe overall crude prevalence of diabetes mellitus among newly diagnosed tuberculosis patients was 283/2185 (13.0%; 95% confidence interval, CI: 11.6–14.4). The marker with the best diagnostic accuracy was point-of-care HbA1c (area under receiver operating characteristic curve: 0.81; 95% CI: 0.75–0.86). A risk score derived using age, point-of-care HbA1c and random plasma glucose had the best overall diagnostic accuracy (area under curve: 0.85; 95% CI: 0.81–0.90). There was substantial heterogeneity between sites for all markers, but the two-step combination test performed well in Indonesia and Peru.ConclusionRandom plasma glucose followed by point-of-care HbA1c testing can accurately diagnose diabetes in tuberculosis patients, particularly those with substantial hyperglycaemia, while reducing the need for more expensive point-of-care HbA1c testing. Risk scores with or without biochemical data may be useful but require validation.

ФУНКЦІОНАЛЬНІ ПОРУШЕННЯ ПЕЧІНКИ У ХВОРИХ З УПЕРШЕ ДІАГНОСТОВАНИМ ТУБЕРКУЛЬОЗОМ ЛЕГЕНЬ

Мета роботи – вивчити гемограму та біохімічний аналіз крові у хворих на вперше діагностований туберкульоз (ВДТБ) легень при вступі в стаціонар і через два місяці лікування, зв’язок із функціональними порушеннями печінки, представити кореляційний портрет показників вимірювань.Пацієнти і методи. Було обстежено 30 осіб: І-ша група практично здорові донори (контрольна) – 15 осіб, та ІІ група – 15 хворих на вперше діагностований туберкульоз легень (ТЛ) до лікування і через два місяці терапії протитуберкульозними препаратами першого ряду.Спостереження проводилось протягом інтенсивної фази лікування – 2 місяці. Всім пацієнтам виконувалися стандартні біохімічні дослідження крові. Розгорнутий аналіз крові проводився на гематологічному аналізаторі BC-3000 Plus Auto Hematology Analyzer (China, 2007). Також був побудований кореляційний портрет залежності між показниками загального та біохімічного аналізу крові хворих на ВДТБ.Висновок. При аналізі кореляційного портрета залежності між показниками загального та біохімічного аналізів крові хворих на ВДТБ встановлено, що найбільш важливими є такі показники загального аналізу крові: гранулоцити, гематокрит, середній об’єм еритроцитів, середній вміст гемоглобіну в еритроциті, кількість тромбоцитів. У біохімічному аналізі крові мають значення АлАТ і ГГТП, після інтенсивної фази лікування – непрямий білірубін, ЛДГ і ЛФ.

Effect of smoking on acute phase reactants, stress hormone responses and vitamin C in pulmonary tuberculosis.

Chronic inflammation, possibly exacerbated by cigarette smoking, is considered to be the primary cause of pulmonary damage in patients with tuberculosis (TB). However, the mechanisms which underpin these harmful inflammatory responses, have not been well documented. The current study was undertaken to determine possible associations between systemic biomarkers of inflammation (acute phase reactants, stress hormones, leukocyte vitamin C) and smoking status in patients (n=71, 20 smokers) with newly-diagnosed pulmonary TB presenting at a tertiary hospital, Johannesburg, South Africa. Plasma concentrations of C-reactive protein (CRP), ferritin, cortisol, epinephrine, norepinephrine, dopamine and leukocyte vitamin C were measured using a combination of immunonephelometric, radioimmunoassay, immunochromatographic and spectrophotometric procedures. Demographic, clinical and laboratory data was captured and analysed by parametric and non-parametric analyses where appropriate. Smokers were predominantly males (P<0.0001), of older age (P<0.0003) with a significantly lower body mass index (P<0.03). Plasma levels of CRP, ferritin and dopamine were higher in the group of smokers in the setting of lower levels of epinephrine, and leukocyte vitamin C, with CRP and vitamin C attaining statistical significance (P<0.04 and P<0.02 respectively). Those of cortisol and norepinephrine were comparable to those of non-smokers, as were radiographic changes and clinical indices of disease activity. Cigarette smoking is associated with an exaggerated systemic inflammatory response in pulmonary TB in the setting of decreased concentrations of leukocyte vitamin C. Although no significant associations with radiographic changes and most clinical indices of disease activity were evident on presentation, these pro-inflammatory interactions may have prognostic significance.

Association between body mass index and diabetes mellitus in tuberculosis patients in China: a community based cross-sectional study

BackgroundWe planned to determine the association of body mass index (BMI) with diabetes mellitus (DM) and impaired fasting glucose (IFG) in Chinese pulmonary tuberculosis (PTB) patients.Methods3,505 newly-diagnosed PTB patients registered in PTB clinics in Linyi of China between September 2010 and March 2013 were enrolled. DM and IFG were identified based on fasting plasma glucose levels. ROC analysis was used to predict the ability of screening of BMI for DM and IFG in PTB patients.ResultsCompared with 18.5–23.9 kg/m2, patients with DM and IFG had significantly increased trends when BMI ≥ 24.0 kg/m2, and aORs were 2.28 (95%CI 1.44–3.60) and 1.30 (95%CI 1.04–1.64), respectively. After adjustment for age, gender, and educational level, there was an increased odd in BMI ≥ 23.41 kg/m2 for IFG, and a decreased odd in BMI < 19.82 kg/m2 for DM (p < 0.05). The cut-offs of BMI for screening IFG and DM in PTB patients were 22.22 kg/m2 (AUC 0.56) and 22.34 kg/m2 (AUC 0.59).ConclusionsIn PTB patients, BMI is significantly associated with IFG and DM. However, the predictive power of BMI was not sufficient, so it may only be a limited screening tool for DM and IFG among PTB patients in China.

Reported outcomes in phase II studies of newly-diagnosed pulmonary tuberculosis

Background Tuberculosis (TB) remains a major killer amongst infectious diseases. Current treatment involves a four-drug regimen for at least six months. New drugs and regimens are required to shorten treatment duration, reduce toxicity and combat drug resistance however the optimal methodology to define the critical path for these regimens is not well-defined. We undertook a literature review to summarise outcomes reported in phase II trials of patients with newlydiagnosed pulmonary TB to determine the necessity for a core outcome set in TB.

Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010.

IntroductionEarly treatment of Tuberculosis (TB) cases is important for reducing transmission, morbidity and mortality associated with TB. In 2007, Federal Capital Territory (FCT), Nigeria recorded low TB case detection rate (CDR) of 9% which implied that many TB cases were undetected. We assessed the knowledge, care-seeking behavior, and factors associated with patient delay among pulmonary TB patients in FCT.MethodsWe enrolled 160 newly-diagnosed pulmonary TB patients in six directly observed treatment short course (DOTS) hospitals in FCT in a cross-sectional study. We used a structured questionnaire to collect data on socio-demographic variables, knowledge of TB, and care-seeking behavior. Patient delay was defined as > 4 weeks between onset of cough and first hospital contact.ResultsMean age was 32.8 years (± 9 years). Sixty two percent were males. Forty seven percent first sought care in a government hospital, 26% with a patent medicine vendor and 22% in a private hospital. Forty one percent had unsatisfactory knowledge of TB. Forty two percent had patient delay. Having unsatisfactory knowledge of TB (p = 0.046) and multiple care-seeking (p = 0.02) were significantly associated with patient delay. After controlling for travel time and age, multiple care-seeking was independently associated with patient delay (Adjusted Odds Ratio = 2.18, 95% CI = 1.09-4.35).ConclusionFailure to immediately seek care in DOTS centers and having unsatisfactory knowledge of TB are factors contributing to patient delay. Strategies that promote early care-seeking in DOTS centers and sustained awareness on TB should be implemented in FCT.

Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010

Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010

Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010

Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010

Rifabutin for the treatment of newly-diagnosed pulmonary tuberculosis: a multinational, randomized, comparative study versus rifampicin

Setting: Patients with newly-diagnosed drug-sensitive, radiographically active and bacteriologically confirmed pulmonary tuberculosis recruited at 6 centres in Argentina, Brazil and Thailand. Objective: To assess the efficacy, tolerability and toxicity of two regimens containing different daily dosages of rifabutin in comparison with rifampicin. Design: Multicentred, randomised, comparative study. In each group, study medications were administered daily for 6 months combined with isoniazid (6 months), and with pyrazinamide and ethambutol (both stopped after 2 months). Treatment success patients were followed-up for up to 2 years. Results: A total of 520 patients were enrolled and randomly assigned to receive either rifampicin (n = 175), or rifabutin 150 mg (n = 174) or rifabutin 300 mg (n = 171). Considering all patients with positive baseline culture, the success rates at the last valid observation for each patient were 89%, 94% and 92% in the rifampicin, rifabutin 150 mg, and rifabutin 300 mg groups, respectively. The median time to culture conversion was comparable in the 3 groups and was 34 days for rifampicin and 37 days for each of the rifabutin groups. During the drug-free follow-up period, one relapse occurred in the rifampicin group, and two in each of the rifabutin groups. The 3 treatment schedules appeared well tolerated. No patients had to discontinue therapy because of an adverse event in the rifabutin 150 mg group, compared to one in the rifampicin and 5 in the rifabutin 300 mg group. Conclusion: All 3 regimens proved effective and well tolerated. Rifabutin at 150 mg/d showed the best risk-to-benefit ratio, in that this group had the highest proportion of patients completing treatment, the highest bacteriological conversion rates and the lowest incidence of adverse events.

Ethambutol plus isoniazid for the treatment of pulmonary tuberculosis-A controlled trial of four regimens

A controlled clinical trial of 4 regimens was undertaken in patients with bacteriologically positive, newly-diagnosed pulmonary tuberculosis. The regimens were: ethambutol 15 mg/kg plus isoniazid 400 mg, daily (E 7H 7) ; ethambutol 45 mg/kg plus isoniazid 15 mg/kg, twice a week (E 2H 2) ; ethambutol 90 mg/kg plus isoniazid 15 mg/kg, once a week plus isoniazid 15 mg/kg, mid-way between the weekly doses (E 1 H 2) ; and ethambutol 90 mg/kg plus isoniazid 15 mg/kg, once a week (E 1H 1). All patients received streptomycin 1 g plus ethambutol 25 mg/kg body-weight plus isoniazid 400 mg daily for the first 2 weeks. The total duration of treatment was 12 months for all patients. There were 484 patients admitted to the study. After excluding 60 (41 with initial drug resistance to isoniazid), there remain 424 patients (107 E 7H 7, 101 E 2H 2, 107 E 1H 2, 109 E 1H 1) in the main analyses. The pretreatment characteristics of the 4 groups were broadly similar. A favourable response at 12 months was observed in 96%, 88%, 93% and 75% of patients respectively: the differences between the E,H, regimen and the other 3 regimens were all significant (P≤0.03) as was that between the E 7H 7 and E 2H 2 regimens (P=0.05). Among the slow inactivators of isoniazid, the proportions with a favourable response at one year were similar in the 4 groups (range 95-91 %). However, among the rapid inactivators, the proportion with a favourable response in the E 1H 1 group was only 57%. There was suggestive evidence that the E 1H 2 regimen was superior to the E 2H 2 regimen. Of the patients with bacteriologically quiescent disease at 1 year, approximately a half, at random, had no further chemotherapy and were followed up for a 4-year period. Bacteriological relapse requiring retreatment occurred in 15 % of 54 E 7H 7 patients, 26 % of 38 E 2H 2, 33 % of 43 E 1H 2 and 54 % of 37 E 1H 1 patients, a significant difference (P<0.001). A final evaluation of long-term (5-year) favourable response achieved by the 12-month regimens was 83 % for the E 7H 7, 63 % for the E 1H 2 and 33 % for the E 1H 1 regimens. In general, the regimens were well tolerated and the incidence of adverse reactions to the drugs was low. Of the 424 patients, 6 (1.4 %) developed a visual disturbance during the year of chemotherapy.

Side-effects of drugs used in directly observed treatment short-course in newly diagnosed pulmonary tuberculosis subjects in Nigerians: A controlled clinical study

A clinical study was carried out between January 1996 and December 1997 in Iwo Nigeria to determine among others the types and frequency of occurrence of side-effects of anti-tuberculous drugs in the 8-month regimen recommended by the Nigerian National Tuberculosis Control Programme Committee (NTCP) for newly diagnosed (ND) Pulmonary Tuberculosis (PTB) cases. This was compared with a 6-month regimen used within the same population of ND PTB subjects at Iwo Nigeria. 65 (13%) of the 500 patients in group one on the 8-month regimen had various side-effects while 7 (14%) of the 50 patients in group two on the 6-month regimen manifested various side-effects. The side-effects rate and frequencies were similar and in both, they were mild and did not materially lead to major change of the anti-tuberculous medications. The regimen used in this study in group one (NTCP recommended) and group two recorded low incidence of side-effects. It confirmed that Directly Observed Treatment Short-course (DOTS) when applied with the recommended regimen by the Nigerian NTCP is effective and is characterised by low and minor side-effects.