EFFECTIVENESS OF DOTS THERAPY UNDER RNTCP-DOTS STRATEGY IN PAEDIATRIC TBEXPERIENCE FROM WESTERN INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 58
Abstract
BACKGROUND Though estimated one million new cases of tuberculosis occur in children worldwide each year, paediatric TB has not been given the same priority as its adult counterpart. TB in children needs to be identified promptly and managed effectively. The DOTS strategy appears to be highly effective for paediatric TB, as reported by studies from all over the world. The aim of this study is to evaluate the efficacy of the DOTS strategy in the management of paediatric TB patients and factors affecting the outcome of paediatric TB patients. MATERIALS AND METHODS A prospective study is conducted from December 2010 to August 2011 at a tertiary care paediatric institute from western India. The patients presenting with signs and symptoms of tuberculosis were diagnosed with RNTCP guidelines and put on DOTS treatment. The patients on DOTS but presenting with relapse, treatment failure and defaulters were also included. At the end of treatment, the outcome was assessed in terms of treatment completion, cure rate, failure rate, relapse and drug resistance. RESULTS Of the total 104 patients, the treatment outcome was assessed in 96 patients. 81.73% completed treatment, 10.57% were declared cured, 1.92% patients cured with extending primary regimen, 4.80% defaulted and one child died. High prevalence of TB was seen in females (62.5 %) than males (37.5 %). There is high rate of treatment completion and cure in extrapulmonary TB (95.92%). There are more defaulters in pulmonary TB (7.23%). There is no significant difference in treatment completion in pulmonary and EPTB. (P> 0.05). CONCLUSION The DOTS strategy appears to have improved TB treatment success. Sex, nutrition and type of tuberculosis have significant impact on outcome of treatment. The present definition of cure given by RNTCP is with reference to sputum positive cases only and cannot be applied to paediatric cases. So, the definition should be revised to include guidelines for cure in paediatric TB.
Authors and Affiliations
Nikhil Dhananjay Kadam, Sambhaji Shivaji Wagh, Uday Chandrapalsingh Rajput, Rajendrakumar Appa Surawashi, Supriya Rode, Sandeep Jagdale, Suhas Suhas Khaire, Shailesh Rathod
Keywords
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- DOI 10.14260/Jemds/2017/933
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