Abstract
It is important to know the outcome of MDR-TB treatment in a country, as many social and therapeutic factors may influence it. We have carefully kept longitudinal data of all MDR TB cases seen by us. The data of cases seen in last 10 years was analyzed to correlate these factors with the outcome. A total of 64 cases were evaluated. The mean age of diagnosis of TB was 28 years with a range of 13 to 65 years. The morbidity was long with a mean of 3.69 years. 30/64 (46.87%) patients had received DOTS as per the national programme.The mycobacteria were resistant to 5.66 drugs on an average. The patients averagely consulted 2.7 doctors for their treatment. 23/64 (35.93%) were lost to follow up. 4 are under treatment for less than 1 year. 7 patients are under treatment for more than 1 year out of which 5 (71.42%) show favorable response and 2 (28.57%) are still sputum positive. Remaining 30 patients had an outcome, out of which 25 (83.33%) got cured, 5 (16.66%) died. Those who defaulted fewer times had a better outcome (0.92defaults in cured patients as against 3.6 defaults in expired patients). 5.6 (28/5) regimens were used in expired patients whereas 3.36 (84/25) regimens were used in those who got cured. Single drug was added to a regimen 12 times in expired patients (2.4 times per patient) as against 12 times in cured patients (0.48 times per patient). Addition of single drug correlated with poorer outcome. Regimen was changed without doing mycobacterial culture 7 times in expired patients (1.4 times per patient) as against 13 times in cured patients (0.52 times per patient). This study highlights some factors in the management of MDR-TB that may help to achieve better outcome.
- © 2011 ERS
