RT Journal Article
SR Electronic
T1 Treatment outcome of multi drug resistant tuberculosis patients in modified DOTS-PLUS: A new strategy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p3307
VO 38
IS Suppl 55
A1 Rajendra Prasad
A1 Abhijeet Singh
A1 Ram Awadh Singh Kushwaha
A1 Rajiv Garg
A1 Sanjeev Kumar Verma
A1 S. Saheer
A1 Girdhar Hosmane
A1 Rahul Srivastava
A1 Amita Jain
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p3307.abstract
AB Background: Multi Drug Resistant Tuberculosis is a worldwide problem and growing hazard to human health.Aims and Objective: To study the treatment outcome with second line drugs in patients of MDR-TB in modified DOTS-PLUS strategy.Methods: A prospective cohort study analysing 98 consecutive patients with MDR-TB attending the Dept of Pulmonary Medicine, CSMMU, between June 2009 to Feb 2010 with follow-up till Feb 2011. All the patients were given medications free of cost as per DOTS PLUS Protocol of India.Treatment included monthly followup,adherence check up,radiological and bacteriological assessment (sputum smear-monthly till conversion then quarterly;culture for MTB-0,4,6,12,18,24 months),health education and monitoring of adverse effects.Patients' outcome considered as “cure” when atleast 2of the last 3 cultures were negative and as “failure” when the same were positive.Results: All the patients had resistance to at least Isoniazid and Rifampicin with mean no. of 3.02 drugs and were seronegative for HIV. Default rate at the end of 6 months and 12 months were observed in 2.1% and 4.1% patients respectively. 5 patients expired in initial 6 months and 2 in next 6 months. Sputum smear and culture conversion at the end of 6 months and 12 months were 80/90 (88.9%) and 75/90 (83.3%) and 81/87 (93.1) and 78/87 (89.7%) respectively. Mean smear and culture conversion time were 3.6±2.1 months and 4.1±2.6 months respectively. Significant side effects were experienced in 14.3% patients.Conclusions: Culture conversion rates at the end of 6 months and 12 months were 83.3% and 89.7% respectively. Modified DOTS-PLUS strategy can be model for treatment of MDR-TB in private sector.