DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20203387

Treatment outcome of multi-drug resistant tuberculosis patients on second line anti-tuberculosis dugs at tertiary care hospital at Himachal Pradesh, India

Anita Kumari, Parveen K. Sharma, Rekha Bansal

Abstract


Background: MDR-TB treatment defaulter are potentially harmful to community as these can relapse and spread infection, developed resistance to second line anti tubercular drugs and may result in to extensive drug resistant tuberculosis (XDR-TB) and major challenges for successful outcome. Objective was to study treatment outcome of multi-drug resistant tuberculosis patients on second line anti-tuberculosis drugs at tertiary care hospital at Himachal Pradesh.

Methods: It was prospective observational study carried out after approval from institutional ethics committee. A total 104 MDR/RR-TB case enrolled for study from November 2012 to October 2013. Data were collected in predesigned proforma and entered in to Microsoft excel worksheet 2007 and analyzed with the help of SPSS software version 17. Chi-square test was applied to find out the association between independent variable and outcome of MDR-TB and p<0.05 was considered statistically significant.

Results: Among all 104 patients initiated on treatment 73.07% patients were alive, completed intensive phase and switch to continuation phase of treatment, 14.42% patients were died, 5.76% defaulted, 0.96% patient was transferred out and 5.76% patients were turned out XDR-TB and switched to regimen of XDR-TB treatment.

Conclusions: Treatment and control of MDR-TB require sound infrastructure and well equipped laboratory facilities to provide quality and prompt diagnosis. Lack of knowledge, awareness, long duration of treatment and defaulters are major challenges for successful outcome.


Keywords


Second line antitubercular drugs, Treatment outcome, MDR-TB

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References


Central TB Division, Directorate General of Health services, Ministry of Health and Family Welfare, Government of India. Guidelines on Programmatic Management of Drug Resistant TB (PMDT) Guideline 2012. New Delhi.

Central TB Division (CTD), Directorate General of Health services, Ministry of Health and Family Welfare, Government of India, Programmatic Management of Drug Resistant TB (PMDT) Guidelines 2017. New Delhi.

WHO. Fact sheet: Multidrug-resistant–TB updates 2017. Available at http:// www.who.int/ tb/challenges/mdr. Accessed on 17 September 2018.

Wahab F, Ashraf S, Khan N, Anwar R, Afridi MZ. Risk factors for multi-drug resistant tuberculosis in patients at tertiary care hospital. J College Phys Surg. 2009;9(3):162-4.

Jain K, Desai M, Solanki R, Dikshit RK. Treatment outcome of standardized regimen in patients with multidrug resistant tuberculosis. J Pharmacol Pharmacother. 2014;5(2):145-9.

Central TB Division, Directorate General of Health services, Ministry of Health and Family Welfare, Government of India. RNTCP annual status report TB India. 2014:175-177.

Patel SV, Nimavat KB, Patel AB, Mehta KG, Shringarpure K, Shukla LK. Sputum smear and culture conversion in multidrug resistance tuberculosis patients in seven districts of central Gujarat, India: a longitudinal study. Indian J Commu Med. 2018;43:117-9.

World Health Organization. Treatment of Tuberculosis: Guidelines for National Programmes. Geneva: World Health Organization; 2003.

World Health Organisation. Guidelines for establishing DOTS Plus Pilot Projects for the management of multidrug-resistant tuberculosis (MDR-TB). 2000.