Three Times Weekly Anti-tuberculosis Treatment of Category 1 and Category 11 Patients of Pulmonary Tuberculosis Under Directly Observed Therapy (dots)
Three Times Weekly Anti-tuberculosis Treatment of Category 1 and Category 11 Patients of Pulmonary Tuberculosis Under Directly Observed Therapy (dots)
THREE TIMES WEEKLY ANTI-TUBERCULOSIS TREATMENT OF CATEGORY 1 AND CATEGORY 11 PATIENTS OF PULMONARY TUBERCULOSIS UNDER DIRECTLY OBSERVED THERAPY (DOTS) STRATEGY IN RURAL AREAS OF SINDH, PAKISTAN.
AUTHORS:
DR: BHURGRI GHULAM RASOOL
DR: SHAMIM-UR-REHMAN
DR: MOMINA TAKI MUHAMMAD
DR: SHAH MURAD MASTOEE.
DR: RAJ KUMAR CHOHAN.
DR: DAHRI GHULAM MUSTAFA.
DR: FAISAL KHAN.
DR: ATIF SHEIKH.
ABSTRACT:
OBJECTIVE:
The purpose of this study was to evaluate three times weekly anti-tuberculosis treatment (ATT) for both category 1 and category 11 patients of pulmonary tuberculosis under directly observed therapy to cut the cost and time required for ATT.
PLACE AND TIME:
This study was conducted at TB clinic, Muhammad Medical College Hospital Mirpurkhas, sindh, Pakistan, from July 2005 to June 2007
Patients and Methods:
130 patients were enrolled for study. 70 patients of category 1 and 60 patients of category11 pulmonary TB who promised to come regularly for treatment three days a week for eight months. Patients were given antituberculosis drugs three days a week under strict observed therapy strategy for eight months according to World Health Organization guide lines for treatment of tuberculosis 2003.
Results:
At the end of eight months in category1, out of 70 patients 67 patients (96%) were cured, 3 patients (4%) who were sputum smear positive at the start of ATT remained sputum positive. In category 11 out of 60 patients, 53 patients (88%) were cured, 7 patients (12%) remained smear positive. Over all cure rates for both categories 1 and 11 was 92%.
CONCLUSION:
Three times a week ATT is as effective as daily regimen of ATT. It must be given under strict DOTS strategy. It saves 65-7-% of drug cost and time as compared to daily regimens.
Key words: Anti-tuberculosis treatment ATT
Directly Observed Therapy Short Course DOTS.
Address for correspondence:
(2) Dr:Ghulam Rasool Bhurgari
Assistant Professor
Department of Pharmacology and Therapeutics
Muhammad Medical College
Mirpurkhas, Pakistan
0333 2871918.
0345-3702876
E-mail [email protected]
INTRODUCTION:
Nearly one third of the global population i.e. two billion people are infected with mycobacterium Tuberculosis and at risk of developing the disease. More than eight million people develop active tuberculosis (TB) every year and about million die (2).This problem is worse in Pakistan. There are no reliable data on the incidence and death caused by TB. It seems to be increasing every year. Although TB affects all classes of people, it is more prevalent in the poor especially of the productive ages of 22-55 years, causing great financial burden and misery to their families.
DOTS(Directly Observed Therapy Short course) was introduced in 1993 by World Health Organization(WHO) DECLARED TB A GLOBAL EMERGNCY IN RECOGNITION OF THE GROWING IMPORTANCE AS A PUBLIC HEALTH PROBLEM.(1)
A component of case management that helps to ensure that patients adhere to therapy is DOT.DOT means that a health care worker or another designated person watches the patient swallow each dose of TB medication. DOT ensures an accurate account of how much medication the patient really took. DOT should be considered for all patients because clinicians are often inaccurate in predicting which patient will adhere to medication regimens on their own. DOT has been shown to be effective when intermittent regimens are used. DOT can significantly reduce the frequency of development of drug resistant and of treatment failure or relapse after the end of treatment. Treatment for drug susceptible TB can be given intermittently if they are directly observed. Using intermittent regimens redress the total number of encounters with the Health worker, making these regimens