Journal article Open Access

THE FREQUENCY OF SUCCESSFUL OUTCOME OF MULTI-DRUG RESISTANT TUBERCULOSIS TREATED AS OUTPATIENT IN A TERTIARY CARE CENTER

Dr. Aurang Zaib Bhutta, Dr. Arif Hussain, Dr. Muhammad Sohail

Tuberculosis [TB] remains one of the biggest health problems in developing and industrialized countries and is associated with high rates of morbidity and mortality. The emergence and spread of Mycobacterium tuberculosis strains resistant to multiple drugs represent a serious threat to TB control worldwide.[1]The estimated prevalence of MDR among new cases was 1.8% and 6.7% among previously treated cases. The estimated number of new MDR-TB cases annually was 8,000.[2]Early diagnosis of active TB and detection of multidrug-resistant [MDR] strains are essential to interrupt transmission.[3]Treatment adverse events, pill burden, rigidity of DOT, psychosocial support and interaction with health personnel pose major challenges to adherence for concomitant anti-TB and antiretroviral treatments.[4, 5]

Objectives: To determine the frequency of successful outcome of multi drug resistant tuberculosis treated as outpatient in a tertiary care center.

Subject and Methods: This was a descriptive cross sectional study done from 13 April, 2018 to 13 OCT, 2018.All the patients fulfilling inclusion criteria having age 20-60 years of either gender under treatment of MDR-TB for more than six months were enrolled in study the from Programmatic Management of Drug Resistance Tuberculosis [PMDT] site at Department of Pulmonology. Informed consent was taken from patients. Strictly exclusion criteria i.e. patients having neurological or psychological problems before diagnoses of MDR-TB [as per medical record in history], co-infection with HIV, was followed to exclude potential confounder and biases. Education status was evaluated & response of treatment was checked in matriculate & under matric patients, also socioeconomic status was evaluated by asking about monthly salary whether below or above 12000, & subsequently their effect on treatment outcome.  HIV screening done through ICT method & DST for tuberculosis done on sputum of the patients in Provincial Reference Lab in Hayat Abad Medical Complex Peshawar for diagnosis.

Results: Total of 151 patients were included in this study, among which males were 94 and females were 57. Mean age was 41 years and S.D 10.82. As per results, 110 [72.84%] patients were having successful outcome. [Table No. 6].

Conclusion: This study concludes that out-patient treatment strategy success rate was 72.84%% and it is feasible and safe for the treatment of MDR-TB patients.

Keywords: Tuberculosis [TB], Programmatic Management of Drug Resistance Tuberculosis [PMDT], Multidrug-resistant [MDR] strains.

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