Three Times Weekly Anti-tuberculosis Treatment of Category 1 and Category 11 Patients of Pulmonary Tuberculosis Under Directly Observed Therapy (dots)
/>
Valid
svn
7
9.7
100.0
100.0
Missing
System
65
90.3
Total
72
100.0
FREQUENCIES
VARIABLES=catone cattwo senty sixty tree svn
/STATISTICS=STDDEV SEMEAN MEAN MEDIAN
/PIECHART FREQ
/ORDER= ANALYSIS .
Pie Chart
1. Sputum smear negative for AFB on three occasions.
2. Radiological opacities on x-ray chest had cleared or healed by fibrosis and calcification.
3. Had gained weight.
4. E.S.R had fallen to normal limits.
5. Hb had risen.
6. Patient was symptoms free and doing his job.
In category 1 67 (96%) patients out of 70 cured.3 patients (4%) who were sputum positive at the start of ATT remained sputum smear positive. In category 11 53 patients (88%) out of 60 were cured.7 (12%) remained sputum positive as they were at the onset of ATT. Over all cure rate in both categories 1and 11 was 92%.
DISCUSSION:
The global target for successful treatment of new sputum smear patients is 85% or more (5) .Average treatment success among national DOTS programs is 82% close to the 85% global target. (6)We achieved the cure rate of 96% for category 1, 88% for category 11 pulmonary TB patients and overall cure rate in both categories 1 and 11 was 92%.
The result is better than the global target for national programs set by WHO. This may be because our total number of patients was small and few multi-drug- resistant (MDR) cases were enrolled.
We think our high cure rate is due to the fact that during this trail we did not let any patient miss even a single dose of medicine. Council ling on every visit was useful. We had to scare the patient that if, he misses even a single dose of medicine he will not be cured. He will die coughing up blood and no medicine will help.
Patient’s family was told that successful treatment of the patient is in their interest also otherwise they will catch the disease from the patient.
DIET ALSO PLAYED A BIG ROLE:
On every visit the patient was weighed and advised to increase his daily consumption of food. Some very anorexic patients were given tonics and steroids.
DOT’S strategy does not just mean giving medicines under peon’s supervision. Doctor and his team treating the patient should win the confidence of the patient by care, sympathy, concern and politeness so that patient can complete his ATT without interruption. This will increase the cure rate and reduce development of MDR.
CONCLUSION:
3 days a week ATT for category 1 and category 11 pulmonary patients under a caring and strict DOTS strategy is more effective and less costly than half heartily supervised daily regimen.
If the total consumption of drugs for 8 months with 3 days a week regimen is compared with that of daily regimen for 8 months there is a saving of 65-70% in cost and time.
This means that with the amount allocated by Government for TB control, as many as three times more patients can be treated. It also means that only 40% sincere and dedicated personal can do better job than being done at present.
KEY MESSAGE:
a) All patients of category 1 and 11 pulmonary tuberculosis can be treated successfully with 3 days a week ATT regimen under DOTS strategy.
b) 3 days a week ATT saves 65-70% money and time,
c) DOTS strategy can improve results if employed with sincerity and devotion.
REFERNCES: