ABSTRACT
Tuberculosis (TB) is a major public health problem in India with high morbidity and mortality. As per the World Health Organization guidelines, the Revised National Tuberculosis Control Program introduced daily directly observed treatment, short-course (DOTS) regimen with a fixed-dose combination with weight bands. This study was undertaken to compare the effectiveness of daily DOTS regimen with intermittent regimen and to assess the proportion of adverse drug reactions in both groups. Materials and Methods: A descriptive study was conducted at a peripheral health institute under one of the TB Units in South Bengaluru. Participants registered for treatment during the third and fourth quarter of 2017 were selected using continuous sampling. Data were collected by case record analysis, structured interviews, and telephonic follow-up. Results: The study included 81 participants, with the mean age of 40 ± 16.1 years. Majority of the study participants 55 (67.9%) were male, and majority (38 [46.9%]) belonged to the upper-lower class. Forty-two (51.8%) of the study participants were on intermittent regimen, and 39 (48.1%) were on daily DOTS regimen. There was 100% sputum conversion at the end of treatment under both treatment regimens. A total of 36 (85.7%) participants under intermittent regimen and nine (23%) under daily regimen developed one or the other adverse drug reactions. The treatment success for participants under intermittent regimen was 38 (90.47%) and that for daily regimen was 35 (89.74%). However, there was no statistically significant difference between the two groups. Conclusion: Both daily and intermittent DOTS regimens are equally effective in TB treatment, but adverse drug reactions were more common with the intermittent regimen.
ABSTRACT
Background & objectives: The global positioning system (GPS) technology along with Google Earth is used to measure (spatial map) the accurate distribution of morbidity, mortality and planning of interventions in the community. We used this technology to find out its role in the investigation of a cholera outbreak, and also to identify the cause of the outbreak. Methods: This study was conducted in a village near Bengaluru, Karnataka in June 2013 during a cholera outbreak. House-to-house survey was done to identify acute watery diarrhoea cases. A hand held GPS receiver was used to record north and east coordinates of the households of cases and these values were subsequently plotted on Google Earth map. Water samples were collected from suspected sources for microbiological analysis. Results: A total of 27 cases of acute watery diarrhoea were reported. Fifty per cent of cases were in the age group of 14-44 yr and one death was reported. GPS technology and Google Earth described the accurate location of household of cases and spot map generated showed clustering of cases around the suspected water sources. The attack rate was 6.92 per cent and case fatality rate was 3.7 per cent. Water samples collected from suspected sources showed the presence of Vibrio cholera O1 Ogawa. Interpretation & conclusions: GPS technology and Google Earth were easy to use, helpful to accurately pinpoint the location of household of cases, construction of spot map and follow up of cases. Outbreak was found to be due to contamination of drinking water sources.