Treatment Outcomes in Patients Treated Under RNTCP in Karad Tuberculosis Unit

Abstract

BACKGROUND: The Revised National Tuberculosis Control Programme (RNTCP), India. OBJECTIVE: To study the treatment outcomes in patients treated under RNTCP &causes of defaulted, death, failure among them. MATERIAL & METHODS: This study was conducted in Karad Tuberculosis Unit (TU), Satara District, Maharashtra. Under Karad Tuberculosis Unit there were nine PHCs, Sub District Hospital and Krishna Hospital, six Designated Microscopy Centre's (DMC), three Integrated Counseling and Testing Centre's (ICTC)-KH, SDH and Undale. All patients registered during January2008 to June 2009 i.e.806 were the study subjects. Before commencement of study permission of District Tuberculosis Officer (DTO) was taken. STUDY TYPE: Longitudinal (Prospective) Study. STUDY PLAN: Patients were interviewed using pre-tested semi structured questionnaires at their residence at the start of treatment, after completion of intensive phase and cohort was further followed up for approximately six months. RESULTS & OBSERVATIONS: Out of 233 new sputum smear positive (NSP) patients, 214 had their sputum smear negative at the end of Intensive phase (IP); hence sputum conversion rate was 91.84% in present study. We found that233newsputum smear positive cases out of which 187 were cured. Thus the cure rate was 80.2%.Out of which 506 smear negative and extra pulmonary patients 462 completed treatment hence treatment completion rate was 91.30%. Out of 233 new smear sputum positive cases, 23 died thus death rate was 9.8%, 5 patients were treatment failure thus the failure rate was 2.1 %. 12 patients defaulted the treatment thus defaulted rate was5.15%.Due to tuberculosis 22 (2.7%) patients died, 27 (3.3%) due to HIV, 17 (2.1%) defaulted due to migration, 5 (0.6%) defaulted due to addiction of alcohol, 3 (0.4%) defaulted due to not relief from symptoms, 1 (0.1%) defaulted due to adverse reaction.16 (2%) failed in due to initial heavy bacillary load. CONCLUSION: It is observed that our regimens produced decline in failure rate, default rate was near expected, death rate was little more. As cure rate was very close to RNTCP objectives, reason might be good case holding in the study. The present study revealed that deaths due to pulmonary tuberculosis even after treatment& HIV renders individuals more susceptible to death as in these study 27 deaths are due to HIV. Some people migrate to their native place or for their work and become defaulted. Default was attributed to migration to their native places in this study. Majority of cases of failure might be due to initial heavy bacillary load.

Outcomes in patients of pulmonary tuberculosis treated under RNTCP & follow up after 6 months

“…In the present study during course of treatment 4 patients (1.9%) were LFU, 3 patient transferred out, 1 patient shifted to private treatment, 6 patients (2.9%) died, treatment failed in 10 patients (4.8%), 184 patients (88.5%) improved and it remained same at end of treatment. In their study Vandana Bhoi et al 6 found that out of 806 patients In our study treatment failure was high (4.8%) as compared with this study (2%), which may be due to initial heavy bacillary load. In our study 1.9% patients defaulted which is lower than Vandana Bhoi et al 6 (3.8%) & (7.7%) SL Chadha study.…”

“…In their study Vandana Bhoi et al 6 found that out of 806 patients In our study treatment failure was high (4.8%) as compared with this study (2%), which may be due to initial heavy bacillary load. In our study 1.9% patients defaulted which is lower than Vandana Bhoi et al 6 (3.8%) & (7.7%) SL Chadha study. 7 Two of our cases defaulted during intensive phase both being daily wage labourers.…”