ABSTRACT
Background: Evaluation of disease outcome is central to the assessment of tuberculosis control programmes. Most of the follow up studies in RNTCP are short term. Five year follow up studies have not been done previously in this region. The objective of the present study is to evaluate the outcome of Category I treatment in smear positive tuberculosis, five years after treatment in terms of relapse, sequelae and death and to know the associated factors. Material and Methods: Patients who had registered for Category 1 treatment during the period 2002 – 2004 were followed up at five years with clinical evaluation, Chest X-ray, ESR and sputum AFB smear. Results: Of the 224 patients who were studied, 81% patients were males. Addictions, including smoking and alcoholism, were prevalent in 136 patients (61%). Treatment success rate at six months was 94.2%. At the end of five years, 124 patients (57.9%) were symptomatic, 59% patients had radiological sequelae, relapse in 10 patients (4.5%), and mortality in 12 (5.4%) patients. Diabetes mellitus was the most common comorbid illness. Smoking and age > 45 years were associated with radiological sequelae. Smoking was significantly associated with mortality. Smokers had worse outcomes in all parameters. Conclusions: Relapse rate was 4.5% and overall mortality was 5.4% at the end of five years. Significant proportion of patients has radiological sequelae. Smoking was the preventable risk factor associated with sequelae, relapse and mortality.