CLINICAL OUTCOME OF PATIENTS OF TUBERCULOSIS UNDER DIRECTLY OBSERVED TREATMENT SHORT COURSE IN A TERTIARY CARE CENTER IN LUDHIANA INDIA

Abstract

PURPOSE: Tuberculosis (TB) has become one of the leading causes of morbidity and mortality in developing countries. Incidence of tuberculosis is increasing in developed countries also, due to emergence of Human Immunodeficiency Virus (HIV), renewing interest and concern with disease. So, study was conducted to evaluate the clinical outcomes of patient during and after completion of WHO recommended Directly Observed Treatment Short course (DOTS) strategy, Sputum conversion rate and adverse events during course of DOTS. METHOD(S): All patients of tuberculosis, coming to chest OPD, DOTS center in our Hospital, Ludhiana in three years, who met the inclusion criteria, were included in study. Patient started on antitubercular treatment according to DOTS regimen. Patients were evaluated and analyzed for any side effects of ATT, improvement in signs, symptoms, default treatment, sputum conversion rate, Failure rate and Cure rate. RESULT(S): Total of 151 patients enrolled, 87 (57.62%) were male, 64 (42.38%) were female with 65 (43.05%) patients in the age group of 21-40 years with the mean age of 35.39 years. 116 (76.82%) had pulmonary tuberculosis and 35 (23.18%) extra pulmonary tuberculosis. Common presenting symptoms were fever (94.83%) weight loss (79.31%) and cough (72.41%). Sputum conversion rate at the end of intensive phase was found to be 87.27% and it was 94.55% at end of continuation phase. In our study 6.62% were having elevated LFT after starting ATT, 2.65% developed skin rash. Only 1.99% developed severe gastritis, 1.32% Patient developed tinnitus and hearing loss because of streptomycin. 2.65% defaulted. Multiple drug resistance (MDR) TB was found 2.65% patient only. CONCLUSION(S): It is concluded that directly observed treatment is more effective, had lesser side effects and more feasible than conventional treatment in managing tuberculosis. CLINICAL IMPLICATIONS: DOTS strategy is useful measure to treat tuberculosis and prevent multidrug resistense tuberculosis.