BACKGROUND AND OBJECTIVES: The past decade has seen a rapid expansion of directly observed treatment, short-course (DOTS) centers throughout India, under the guidance of the Revised National Tuberculosis Control Programme (RNTCP). While expansion has been rapid and extensive, few reports exist detailing individual DOTS centers' experiences, their challenges, and their successes. We present a brief report on the status of a DOTS center being run at a large tertiary care center in northern India for almost four years (2001-2005). METHODS: The DOTS center followed RNTCP guidelines for the evaluation and treatment of suspected TB cases. A register carrying detailed information of all patients seen at the DOTS center was kept by the senior clinician. Data from this register were extracted and analyzed for descriptive measures. RESULTS: A total of 1490 patients were evaluated. Of the 768 patients with cough, 27 per cent (211) were found to be sputum positive for acid-fast bacilli (AFB). Among patients who were initiated on anti-tuberculosis medications, cure was achieved in 92 per cent (71 of 77) of new sputum smear positive patients; treatment completion was achieved in 91 per cent (91 of 100) of extrapulmonary TB (EPTB) and 75 per cent (46 of 61) of sputum-negative pulmonary TB patients. Overall treatment success was achieved in 86 per cent (229 of 266). INTERPRETATION AND CONCLUSION: Treatment results were in keeping with the RNTCP guidelines. Tertiary care centers appear to be excellent place for education of medical students and operational research. The latter is much needed, as HIV-TB co-infection, multi-drug resistant TB, and EPTB continue to be major public health threats even in the era of DOTS.
BACKGROUND AND OBJECTIVES: The past decade has seen a rapid expansion of directly observed treatment, short-course (DOTS) centers throughout India, under the guidance of the Revised National Tuberculosis Control Programme (RNTCP). While expansion has been rapid and extensive, few reports exist detailing individual DOTS centers' experiences, their challenges, and their successes. We present a brief report on the status of a DOTS center being run at a large tertiary care center in northern India for almost four years (2001-2005). METHODS: The DOTS center followed RNTCP guidelines for the evaluation and treatment of suspected TB cases. A register carrying detailed information of all patients seen at the DOTS center was kept by the senior clinician. Data from this register were extracted and analyzed for descriptive measures. RESULTS: A total of 1490 patients were evaluated. Of the 768 patients with cough, 27 per cent (211) were found to be sputum positive for acid-fast bacilli (AFB). Among patients who were initiated on anti-tuberculosis medications, cure was achieved in 92 per cent (71 of 77) of new sputum smear positive patients; treatment completion was achieved in 91 per cent (91 of 100) of extrapulmonary TB (EPTB) and 75 per cent (46 of 61) of sputum-negative pulmonary TBpatients. Overall treatment success was achieved in 86 per cent (229 of 266). INTERPRETATION AND CONCLUSION: Treatment results were in keeping with the RNTCP guidelines. Tertiary care centers appear to be excellent place for education of medical students and operational research. The latter is much needed, as HIV-TB co-infection, multi-drug resistant TB, and EPTB continue to be major public health threats even in the era of DOTS.
Authors: Daniel W Gunda; Igembe Nkandala; Godfrey A Kavishe; Semvua B Kilonzo; Rodrick Kabangila; Bonaventura C Mpondo Journal: J Trop Med Date: 2017-06-11
Authors: Surendra K Sharma; Alladi Mohan; L S Chauhan; J P Narain; P Kumar; D Behera; K S Sachdeva; Ashok Kumar; Priyanka Agarwal; N T Awadh; Avi Bansal; S Baruah; Pranab Baruwa; V H Balasangameshwara; Rani Balasubramanian; A K Bhardwaj; Salil Bhargav; Sarabjit Chadha; V K Chaddha; Manpreet Chhatwal; A L Da Costa; D P Dash; Jaydip Dep; Saroj Dhingra; S Dhooria Harmeet; T R Frieden; Anil Garg; Reuben Granich; Vinay Gulati; Deepak Gupta; Dheeraj Gupta; K B Gupta; K N Gupta; A K Janmeja; M S Jawahar; S L Jethani; S K Jindal; K R John; O P Kalra; V P Kalra; A T Kannan; S Kayshap; G Keshav Chander; S S Khushwa; R S Kushwaha; Vinod Kumar; B Laskar; K R Leela Itty Amma; A T Leuva; K Maitra Malay; A M Mesquita; Thomas Mathew; Yamuna Mundade; Radha Munje; Somil Nagpal; C Nagaraja; Sanjeev Nair; O R Narayanan; C N Paramasivan; Malik Parmar; Rajendra Prasad; A C Phukan; Raj Prasanna; Anil Purty; Ranjani Ramachandran; Rajeswari Ramachandran; C Ravindran; H R Reddy Raveendra; S Sahu; Rohit Sarin; Soumya Sarkar; K C Sarma; P Saxena; Shruti Sehgal; N Sharath; Geetanjali Sharma; Nandini Sharma; P K Shridhar; R S Shukla; Om Singh; N Tombi Singh; Varinder Singh; Rupak Singla; Neena Sinha; Pranay Sinha; Sanjay Sinha; Rajesh Solanki; A Sreenivas; S Srinath; Kandi Subhakar; J C Suri; Palash Talukdar; Jamie Tonsing; S P Tripathy; Preetish Vaidyanathan; R P Vashist; K Venu Journal: Indian J Med Res Date: 2013-02 Impact factor: 2.375