TAILIEUCHUNG - Predictors of relapse among pulmonary tuberculosis patients treated in a DOTS programme in South India

Patients who habitually drank alcohol were considered alcoholics, and patients who habitually smoked and were currently smoking were considered smokers for the purpose of the analysis. In the RNTCP, a new smear-positive TB patient is expected to complete treatment within 7 months (6 months 1 month grace period). For patients whose sputum does not convert at 2 months, the intensive phase is extended by one more month and the duration of treatment extended to 8 months (7 months 1 month grace period). Patients who took longer than the RNTCP norms to complete treatment were considered irregular. Statistical analysis The data were computerised after scrutiny and further edited for completeness of all information. | INT J TUBERC LUNG DIS 9 5 556-561 2005 The Union Predictors of relapse among pulmonary tuberculosis patients treated in a DOTS programme in South India A. Thomas P. G. Gopi T. Santha V. Chandrasekaran R. Subramani N. Selvakumar S. I. Eusuff K. Sadacharam P R. Narayanan Tuberculosis Research Centre ICMR Chennai India OBJECTIVE To identify risk factors associated with relapse among cured tuberculosis TB patients in a DOTS programme in South India. DESIGN Sputum samples collected from a cohort of TB patients registered between April 2000 and December 2001 were examined by fluorescence microscopy for acidfast bacilli and by culture for Mycobacterium tuberculosis at 6 12 and 18 months after treatment completion. RESULTS Of the 534 cured patients 503 94 were followed up for 18 months after treatment completion. Of these 62 12 relapsed during the 18-month period 48 77 of the 62 relapses occurred during the first 6 months of follow-up. Patients who took treatment __SUMMARY irregularly were twice more likely to have a relapse than adherent patients 20 vs. 9 adjusted odds ratio aOR 95 CI . Other independent predictors of relapse were initial drug resistance to isoniazid and or rifampicin aOR 95 CI and smoking aOR 95 CI . The relapse rate among nonsmoking treatment adherent patients with drug-sensitive organisms was . CONCLUSIONS The relapse rate under the DOTS programme may be reduced by ensuring that patients take their treatment regularly and are counselled effectively about quitting smoking. KEY WORDS tuberculosis DOTS India relapse IN THE REVISED National Tuberculosis Control Programme RNTCP of India based on the DOTS strategy patients are treated with an intermittent short-course regimen with drugs administered thrice weekly on alternate The treatment consists of an initial 2-month intensive phase of isoniazid H rifampicin R pyrazinamide Z and ethambutol E followed by a 4-month continuation

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