Outcome of Directly Observed Treatment Short Course ATT in New Sputum Positive Pulmonary TB Patients under RNTCP

Abstract

Background: India is the highest TB burden country accounting for more than one?fifth of the global burden of tuberculosis (TB). To tackle this problem, Revised National Tuberculosis Control Programme (RNTCP) based on the directly observed treatment short course (DOTS) strategy has been made available in the entire country. The present study was undertaken to assess the compliance, bacteriological sputum conversion rates, cure rates, symptomatic improvement during treatment and adverse effects due to DOTS in new sputum positive pulmonary tuberculosis patients.

Methods: This prospective study was conducted at DMC, DOTS Center and Department of Medicine, Silchar Medical College and Hospital, Silchar over a one year period on 50 new sputum smear positive patients (aged >12 years) on Category I DOTS treatment. Patients were followed 2^nd, 4^th and 6^th months. On follow up repeat sputum sample was taken and patients were assessed for improvement and adverse effects.

Results: Majority of patients was symptomatically better at the end of second month; improvement has taken in the form of resolution of cough (70%), hemoptysis (77%), fever (92%), breathlessness (63%) and chest pain (71%). The sputum conversion rates were 84% at 2^nd month and 78% at 4^th month. The overall cure rate was 78%, default rate was 12%, failure rate was 8% and death rate was 2%.Gastrointestinal intolerance was the most common side effect (40%) of initial phase of DOTS.

Conclusion: DOTS is the best available strategy for curing TB patients even in the context of limited resources, resulting in high cure rates and better patient compliance.