ABSTRACT
Background: Treatment outcome is key indicator to assess the effectiveness of TB control program
Objective: To determine the treatment outcome in tuberculosis patients registered at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan
Patients and Methods: All the patients registered at DOTS clinic, Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan from 1[st] January, 2008 to 31[st] December 2009, were followed up till completion of their prescribed regimen to determine the WHO endorsed treatment outcome. Patients were classified according to site of disease [pulmonary vs extra pulmonary], history of previous treatment and sputum smear status
Results: Of the 1607 registered TB patients, majority of the patients [83.9%] were newly diagnosed, young [median age: 30 years] and have pulmonary TB [74.9%]. Overall treatment success rate was 77%. New cases fared better [80.6%] than previously treated patients [53.7%]. Among previously treated group, treatment outcome was as follows; relapse [62.7%], treatment after default [52.7%] and treatment failure [33.3%]. Extra pulmonary tuberculosis cases fare better than pulmonary case with success rate of 87.7% and 72.5%, death rate 11% and 3.2%, failure rate 1.9% and 0.2% and default rate of 6.9% and 10.6% respectively
Conclusion: Considering the WHO standard of 85% treatment success rates, only the newly diagnosed patients were close to achieve the target. Previous exposure to anti tuberculosis treatment especially inadequate one was closely associated with poor outcome. Efforts should be made to ensure proper management of all TB cases
ABSTRACT
Background: Worldwide, tuberculosis and viral hepatitis are common diseases and both remain underdiagnosed and under-treated. Co-infection with tuberculosis and hepatitis is likely to make diagnosis, management and control of either disease difficult and challenging
Objective: To determine prevalence of HCV and HBV infection among PTB patients at Rahim Yar Khan, Pakistan
Patients and Methods: One hundred sputum smear positive pulmonary tuberculosis patients were screened for HCV and HBsAg. In this cross-sectional study, from 1st April to 31st December, 2010 results were analyzed by age, gender, marital, educational and socioeconomic status by using SPSS version 15
Results: Sociodemographic data showed that 66% patients were young between 15-49 years. Only 8 patients had history of blood transfusion, 4 had traveled abroad and none was drug abuser. Most of them were poor. Out of 100 patients [56 male and 44 female] 22% patients were positive for HCV and 3% for HBsAg. Prevalence of HCV infection was significantly higher in married [p value 0.03] and in those with history of blood transfusion [p value 0.004]. No significant statistical difference of prevalence of HCV between male and female, urban and rural, educated and uneducated and in those who traveled abroad or not was found
Conclusion: Prevalence of HCV infection among the pulmonary tuberculosis patients at Rahim Yar Khan [22%] is alarmingly high as compared with general adult Pakistani population [approx. 4.7%]
ABSTRACT
Background: Universal HIV testing for all TB patients regardless of their individual risk factors is being recommended by most of the authorities including WHO in recent guidelines
Objective: To determine the prevalence of HIV infection among Pulmonary TB patients presenting at Department of Pulmonology, Rahim Yar Khan, Pakistan
Patients and Methods: In this cross sectional study, one hundred consecutive newly registered smear positive pulmonary TB patients presented at Department of Pulmonology, Sheikh Zayed Medical College, Rahim Yar Khan from 1[st] April to 31[st] December 2010 were included in this study. Interviews were conducted to record the sociodemographic data and various HIV related risk factors for all patients. Consent was taken from the patients to be included in this study and for HIV testing. Test was done by ICT method at department of pathology of this institute. The data was entered and analyzed in SPSS version 15
Results: Out of 100 TB patients in this study, 56 were male and 44 were female. Majority [51%] of the patients were uneducated. Only 24% were earning more than ten thousands rupees per month. Sixty six percent patients were aged between 15-49 years. All the patients gave their consent for HIV testing. Only 4 of the 100 subjects had travelled abroad, 8 had history of blood transfusion and none of the patients admitted any history of drug abuse. None of the 100 patients in this study was positive for HIV infection
Conclusion: Despite the presence of risk factors in considerable number of participants of this study, HIV infection was not detected in any of the Pulmonary TB patient. This finding put a question mark over universal recommendation of HIV testing in all TB patients worldwide. However, larger study including all TB patients, both Pulmonary as well as Extra Pulmonary is required to confirm this finding