TAILIEUCHUNG - FACTORS ASSOCIATED WITH TREATMENT OUTCOMES IN PULMONARY TUBERCULOSIS IN NORTHEASTERN THAILAND

Sputum examination was carried out at the 2nd, 4th and 6th month as required by RNTCP. All HIV seropositive pulmonary tuberculosis cases were treated with Category 1 regimen, while HIV seronegative patients were treated with either Category 1 or Category III regimens as per RNTCP guidelines. During the period of anti-TB treatment, if the subject failed to turn up for treatment, suitable action was taken as described in the RNTCP to ensure regularity in anti-TB treatment. At the time of the initiation of the study, free antiretroviral therapy was not yet available in India. Whenever a death occurred in the. | FACTORS ASSOCIATED WITH TREATMENT OUTCOMES IN PULMONARY TUBERCULOSIS IN NORTHEASTERN THAILAND Siriluck Anunnatsiri1 Ploenchan Chetchotisakd1 and Christine Wanke2 1Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand 2Department of Medicine and Community Health Tufts University School of Medicine Boston Massachusetts USA Abstract. Tuberculosis and HIV AIDS are both prevalent in Southeast Asia and Thailand. Factors related to treatment outcomes in smear-positive pulmonary tuberculosis were evaluated in 226 adult Thai patients. Of these 31 had a cure or a completion of therapy 7 had treatment failure or death and 31 had treatment interruption. The prevalence of co-morbid diseases was 52 including 19 with HIV. Sputum cultures for Mycobacteria were carried out in 86 cases 38 36 of these 42 were culture positive for Mycobacterium tuberculosis. The rate of drug resistance was 14 5 36 of culture proven tuberculosis and the mortality rate was 7 153 of patients with known outcomes. Of the 7 fatalities 3 were HIV positive and 1 had multi-drug resistant tuberculosis. Factors that were significantly associated with treatment failure death were old age OR 95 CI HIV co-infection OR 95 CI and previously treated tuberculosis OR 95 CI . These high rates of drug resistance and treatment failure in this area suggest that initial sputum cultures and drug susceptibility testing for Mycobacteria should be performed in all patients who have been previously exposed to anti-tuberculous drugs and HIV testing should be performed on all patients with tuberculosis. INTRODUCTION Tuberculosis TB remains a common and deadly disease in the world and has an enormous economic impact on many countries. Nearly one-third of the world s population or billion people are infected with Mycobacterium tuberculosis million people die each year from the disease Dye et al 1999 . The World Health Organization WHO defined a .

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