Perhimpunan Dokter Paru Indonesia - Outcomes of directly observed treatment for drug resistant tuberculosis
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Outcomes of directly observed treatment for drug resistant tuberculosis




Manu Chopra1, C.D.S. Katoch1, G.D.S. Madan2 and Barun Chakrabarty3
1Pulmonary Medicine, Military Hospital Namkum, Ranchi, JharkhandIndia, 2Radiology, Military Hospital Namkum, Ranchi, JharkhandIndia, 3Pathology & Microbiology, Military Hospital Namkum, Ranchi, JharkhandIndia

Introduction: Drug resistant ? tuberculosis (DR-TB) is a man-made disorder & needs human care for cure i.e. directly observed treatment (DOT). We followed the WHO1 recommended pragmatic approach for DR-TB cases in full 'letter & spirit', i.e. by offering full duration of treatment to DR-TB cases as indoor patients thereby, observing them clinically, microbiologically, and radiologically

Aim & Objectives: To assess the outcome of DOT for DR-TB

Material & Methods: All DR-TB cases diagnosed from Jan 2012 - Dec 2015, using culture, nucleic acid amplification tests or line probe assays were subjected to treatment regimens as per updated WHO DR-TB guidelines1. They were managed as indoor patients and were routinely evaluated clinically (daily), microbiologically (monthly smears & cultures in intensive phase & 3 monthly thereafter), radiographically (3 monthly) and hematologically &biochemically (monthly initially and 3 monthly or as & when required) till complete duration of therapy.

Results: Of the 412 cases of Pulmonary TB managed from Jan 2012- Dec 2015, 81 (19.67%) cases had primary drug resistance, of which 04 (4.9%) were XDR-TB & 04(4.9%) were MDR-TB cases. Remaining (90.12%) TB cases were polydrug resistant TB. Two cases (2.47%) succumbed to illness and 02 (2.47%) continued to be sputum smear & culture positive despite DOT. The remaining 77 (95.06%) cases were declared cured and are being followed up post treatment

Conclusion: Though man's carelessness has created DR-TB, the study shows that human care by DOT can effectively cure DR-TB

References: 1. Guidelines for the programmatic management of drug resistant tuberculosis update 2011. Geneva, World Health Organization.

http://erj.ersjournals.com/content/48/suppl_60/PA2687



PDPI Surakarta. 06/03/17.



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