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Purpose: To describe the increase in prevalence of ethambutol-induced optic neuropathy (EON) in patients presenting to a single tertiary referral eye care center in India after introduction of weight-based fixed dose combinations and an increase in duration of ethambutol use from 2016 in the Revised National Tuberculosis Control Program. Methods: This was a retrospective, observational, referral hospital-based study of 156 patients with a diagnosis of EON presenting to a single tertiary referral eye care center between January 2016 and December 2019. The main outcome measure was to assess the increase in prevalence of EON cases presenting to our tertiary care institute. Results: During the 4-year study period, 156 new patients were diagnosed with EON. A total of 101 patients (64.7%) were males and 55 (35.3%) were females. The most common age group affected was 41–60 years. The significant complaint at presentation was decreased vision in all the patients. A rising trend in the number of patients diagnosed as EON was seen, with the prevalence increasing from 16 cases in 2016, 13 cases in 2017, and 31 cases in 2018 to 96 cases in 2019. Conclusion: The results of this study indicated an alarming increase in the trend of EON cases presenting to our tertiary care institute.
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Background: Multidrug resistant tuberculosis (MDR TB) requires treatment with expensive, toxic, anti-tubercular drugs over a longer duration. Adverse drug reaction (ADR) to second line anti tubercular drugs affect compliance and hence treatment outcome. The primary objective of this study was to analyse ADRs and if these resulted in change or permanent suspension of drug. We also analysed treatment outcome, treatment adherence and co morbidities associated with MDR patients.Methods: A retrospective study was carried out at DOTS plus site in department of Pulmonary Medicine, Goa Medical College on registered MDR cases from November 2011 to October 2016. Socio demographic profile, diagnosis, treatment and ADRs were evaluated, ADRs were evaluated for frequency, causative drugs, management aspect and impact on treatment outcome.Results: Out of 201 MDR cases, 99 cases had 167 ADRs. Majority of patients having ADRs were in age group of 30-50 years with mean眘tandard deviation 36.82�.47, 59 (59.59%) males and 40 (40.40%) females, 92 (92.92%) retreatment cases and 7 (7.07%) newly diagnosed. Majority of ADRs were vomiting 31(18.56%), joint pain 31 (18.56%), gastritis 21 (12.57%), hearing impairment 16 (9.58%), numbness in leg 14 (8.38%), depression 12 (7.18%). Treatment outcome of cases with ADR was cured 45 (45.45%), treatment completed16 (16.16%), progressed to XDR 6 (6.06%), transferred out 5 (5.05%), defaulter 14 (14.14%), death 13 (13.13%).Conclusions: It is very important to recognise at the earliest and treat the ADRs with least modification of the treatment regimen to have a good treatment outcome.
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Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria spread by droplet infection.According to global TB report 2017, there were approximately 28 lakhs cases of TB in India accounting a quarter of the world TB cases. Today, it is the fastest-expanding and the largest program in the world in terms of patients initiated on treatment and the second largest in terms of population coverage. The objective of this study is to assess the socio-demographic profile of the patients attending revised national TB control programme (RNTCP) clinic, to determine the nature of disease, its co-morbidities, seasonal variability and treatment profile of the patients attending the RNTCP clinic during this study period.Methods: This was a retrospective record-based study conducted in RNTCP clinic of KPC Medical College and Hospital, Kolkata. Details of all the 684 patients who were enrolled under RNTCP from the year 2014 to 2018 were collected from RNTCP records. Data was analyzed using suitable software.Results: 684 cases were registered and treated under directly observed treatment, short-course (DOTS) during the study period with 41% completing treatment. 84.3% were new TB cases. 23.61% were sputum smear positive. Males (67.25%) contributed to more in cases. Maximum patients visited during March to June. 74.87% of the total patients were diagnosed with pulmonary TB. Pleural effusion was the commonest form of extrapulmonary TB (42.75%).Conclusions: The number of TB cases showed a decreasing trend over the years. Males contributed to a greater number of cases with majority being contributed by the age group 21-30 years.
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Background: Tuberculosis affects all socio-economic persons and has an enormous economic impact on many countries. India accounts for a quarter of the global burden of tuberculosis. It is a chronic stigmatized public health and social challenge in almost all communities of the developing countries. The aim of the present study was to assess the socio-demographic characteristics of tuberculosis patients in urban area and their relation with current tuberculosis epidemiological situation.Methods: A retrospective type of study was conducted from July, 2010 to September, 2010 in tuberculosis units and data was collected from tuberculosis registers and all patients were interviewed with their consent. All collected data were transferred in a computer and analyzed using Excel worksheet. Tuberculosis patients were not on directly observed treatment, short-course (DOTS) regime and not gave consent, excluded for the study.Results: In our study, total of 363 tuberculosis patients interviewed in which maximum number i.e., 90 (24.79%) of the study population belonged to the age group 26-35 years, 216 (59.51%) were male, 195 (53.72%) were from urban population, 269 (74.1%) Hindu by religion, 278 (76.58%) married, 139 (38.29%) illiterate, 126 (34.71%) unemployed, 122 (33.61%) belonged to socioeconomic class V, 202 (55.65%) were from nuclear families. 262 (72.18%) patients had pulmonary tuberculosis and 101 (27.82%) had extra-pulmonary tuberculosis Majority of patients 264 (67.77%) were in category-I followed by 81 (22.7%) in category II. And 36 (9.92%) patients were being treated as category-III.Conclusions: It has a dreadful impact on the economic wellbeing of individual, their families and the entire community.
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Background: Tuberculosis is among the most important causes of death from a single infectious agent and a major public health problem causing an enormous burden of disease and economic impact especially in the developing countries. Pulmonary tuberculosis is the most common form of tuberculosis causing >85% of all tuberculosis cases. The smear conversion rate is an operational indicator for the directly observed treatment short course (DOTS) strategy of Revised National Tuberculosis Control Programme (RNTCP) in India.Methods: A longitudinal study was conducted in DMC, RRMCH, in the first two quarters of the year 2013 i.e., from January 1st to June 31st of the year 2013. All 130 adult category I (new) sputum smear positive cases that attended DMC, and registered under RNTCP constituted the sample for the study. Data was collected by interview method by using pre-tested, semi-structured questionnaire. Data was analyzed using SPSS version 20.0.Results: Majority of the study subjects was >50 years, Hindus, illiterates, belonged to nuclear family from rural area belonged to upper lower socio-economic class. The overall sputum smear conversion rate is 92.4%. Lower sputum smear conversion rate was observed in the following risk factors like the male gender, smoking, diabetes, initial high pre-treatment smear grading and poor drug compliance.Conclusions: The overall sputum conversion rate at the end of two months of intensive phase under (DOTS) chemotherapy in 118 sputum smear positive (cat I) new pulmonary tuberculosis patients in Designated Microscopy and Treatment Centre (DMC) Rajarajeswari Medical College and Hospital was 92.4%.
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Aim: The present study was undertaken to find out the sex differences in the notification rates and treatment outcomes of Tuberculosis (TB) patients, registered under the Revised National Tuberculosis Control Programme (RNTCP) in a rural Tuberculosis Unit (TU) in Thorrur, Warangal Dist., Telangana. Methods: This is a retrospective record based study was carried out among a total of 585 cases registered under the RNTCP between January'2011 to December'2012. Notification rates of TB, clinical forms of Tuberculosis and disease treatment outcomes recorded in the registers were analysed. Based on genders outcomes were defined in accordance with the standard RNTCP definitions. Results: Among the total of 585 patients 220 (80%) were male and 55 (20%) were female with male female ratio of 4:1. In patients less than 20 years of age the notification rates among males and females were similar. In other age groups male were more likely to be notified compared to females and the difference was statistically significant, while new smear positive and retreatment cases were significantly more than females, among females new smear positive and new extra pulmonary cases significantly lower. Among the new smear positive in females 39.3% were cured compared to 49.4% males which was again significant statistically. Male patients outnumbered female in all unfavorable outcome like death, failure, and default. Conclusion: The present study demonstrates a gender difference in the notification rates, clinical presentations and treatment outcomes of patients with TB integrated research is necessary to find the reasons for these differences. Such studies will be helpful in improving the efficacy of the RNTCP
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Background: WHO estimates that annually 3 million deaths occurs due to tuberculosis and will reach to more than one billion in 2020. In India, more than 40% of population is infected. The revised national tuberculosis control programme (RNTCP) uses directly observed treatment, short-course (DOTS) therapy strategy to reduce mortality and morbidity, reduce transmission. Compliance to DOTS therapy is one of the important factors that affect the treatment outcome. Hence this study was done to assess the drug compliance rate of adults registered under RNTCP in the past one year and first three months after starting the study and to explore the factors associated with drug compliance.Methods: A longitudinal study was done in Bahour Commune Panchayat with subjects registered under RNTCP from January 2011 to March 2012. They were followed-up by house visit, interviewed using a semi-structured questionnaire.Results: The mean age was 44±13 years, 35 (68.6%) males were illiterate. About 60 (85.7%) belong to Class IV socio-economic status; 15 (29.4%) and 33 (64.7%) of adults had smoking and alcohol intake respectively; 03 (04.3) were diabetic. The treatment compliance rates were cured 64.3% (45/70), completed 27.1% (19/70), default 2.9% (02/70), failure 5.7% (04/70).Conclusions: Male being diseased in the productive age-group, will not only affect the health of the patient but also affect the family’s economic status. Most of the males gave history of alcohol intake, for which they require constant motivation for compliance to the treatment.
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Introduction: The Revised National TB Control Programme(RNTCP), a state-run tuberculosis (TB) control initiative of theGovernment of India, has been very successful inimplementing the DOTS strategy in India. It is based onsputum smear diagnosis and a reliable supply of good qualitydrugs, both provided at no cost to the patient.Methodology: In this cross-sectional study, the data wascollected from 150 eligible patients during the period January2018 to July 2019, from a peripheral DOTS TB centre and 5private medical practitioners representing both private andgovernment clinics. 75 patients enrolled from private medicalpractitioners were not enrolled under RNTCP programme.Result: 150 patients were enrolled in this study. 75 patientswere enrolled in DOTS Programme in a Rural Dots Centrewhile remaining 75 were investigated and treated by privatepractitioners. Both groups of patients were given standardisedCategory 1 regimen. None of the patient had received previousTB treatment.Conclusion: This study concludes that reducing out-of-pocketcosts to patients may increase the access to the poor peopleand thus promoting the universal access of TB care servicesas well.
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Background: The aims and objectives were to study the progression from tuberculosis to multi drug resistance-TB in revised national tuberculosis control programme: perspectives from health system care givers.Methods: The study was carried out in TB Sanatorium ITKI, Sadar Hospital Ranchi and RIMS Ranchi. The interview of various health personnel including SAHIYAs was taken using a semi-structured questionnaire based on programmatic management of multi drug resistant tuberculosis guidelines -2016.Results: Among Doctors knowledge level was good compared to other health personnel which had mean value 7.33 (±2.79), laboratory technician 3.45 (±2.64), STS 4.67 (±1.59), Sahiya 2.1 (±0.73). Regarding capacity enhancement level all health personnel needed refresher trainings in which doctors got 4.67 (±1.58), laboratory technician 3.45±2.64, STS 1.72±0.34, and Sahiya 0.5±0.52. Specially sahiya needs training regarding MDR-TB because they are the connecting link between health system and community. Regarding execution level, Doctors got 1.86 (±0.74), laboratory technician 1.64 (±0.56), STS 1.64 (±0.56) and Sahiya (ASHA) 2.2 (±0.44). Sahiya were better than other health personnel at execution level.Conclusions: Advocacy, communication, and social mobilization are important aspects of TB control, Policy makers and administrators should be sensitized for need of adequate and sustained funding for TB control to ensure quality capacity building. They need to provide continuous and quality training of staff at different levels and retention of trained staff and periodic reviews to identify gaps and take corrective steps.
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Tuberculosis control can significantly be increased if more effort is given to improve knowledge and attitudes of physicians towards prevention and control of disease. This study aimed to assess the knowledge about recent change in RNTCP guideline (2016) for diagnosis and treatment of tuberculosis among medical students and interns. Sample size was 295, including students of 3rd Professional MBBS part 1, 3rd Professional MBBS part 2 and Interns of a Medical college in West Bengal. The study was done with the help of specially prepared questionnaires. Mean scores of different batches did not show any significant difference . mean score of 3rd Prof part 1 students was best. Overall response was not satisfactory as many questions had more than 50 percent wrong responses. 3rd Prof MBBS part 1 students , probably after passing microbiology and pharmacology in 2nd Prof MBBS examination fared better in the questionnaire than their senior fellows.
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Background: The RNTCP (Revised National Tuberculosis Control Programmed) in India provide a strong framework for the outpatient management of tuberculosis yet very less literature is available on tuberculosis in hospitalized patients. Several factors including the clinical and socio- economic status contribute to the burden of hospitalization in tuberculosis. Methods: 150 total numbers of cases were included who had infection of tuberculosis. This study was conducted in the Department of TB & Respiratory Diseases, Shri Dev Suman Subharti Medical College, Dehradun. Results: ‘Among the all cases we found that, 40% having extra pulmonary, 37.3% pulmonary, disseminated 22.7% tuberculosis infection. Conclusion: This study concludes that extra pulmonary TB was most common followed by pulmonary TB.
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Background: The challenge is to make all HIV-infected people aware of their status so that they may prevent the transmission of HIV to others. Only 25–30% of the people who are HIV positive in India are aware of their HIV status. Guntur district has a high epidemic potential with established transmission among the general population. The objective of the study was to study the socio demographic profile and HIV positivity rates among clients visiting an Integrated Counselling and Testing Centre (ICTC).Methods: This descriptive study is based on secondary data from the records of the ICTC. The data is entered and analysed with MS Office Excel and EPI Info statistical package. Important findings were tested for statistical significance at 5% level of significance.Results: Of the 6940 clients attending the ICTC, 43.34% are antenatal women (HIV positivity of 0.27%). Of the rest, provider initiated clients are 94.02% (HIV positivity 4.38%) and client initiated 5.9% (HIV positivity 20%). The difference of HIV positivity is highly significant (p<0.000001). 61.1% of the clients were found to be between the ages 25 to 49 years. Among the client initiated, more women (7.4%) were seen to be attending the ICTC (p<0.05). High risk professions identified were hotel workers (7.3% HIV positive), local transport workers (6.01%) and petty business (6.22%). Housewives were found to have 3.2% HIV positivity.Conclusions: Self-referral to ICTC is still very poor. The epidemic is shifting to the general populations. HIV/AIDs education efforts aimed at the population in general must be increased.
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Background: Between 2006 and 2015, the prevalence of MDR-TB has been found to be as high as 39.9% in some states. Approximately 35.8% of all previously treated patients developed MDR-TB. The objective of the present study was to identify demographic and health characteristics of patients as well as incidence and pattern of the adverse drug reactions caused by antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This 12 months study of observational study was conducted at a DOTS centre. MDR-TB diagnosed patients treated with DOTS Plus regimen were enrolled after getting informed consent. Patient information was recorded. Patient follow-up was conducted to identify the incidence and pattern of ADRs.Results: A total of 115 patients were enrolled. Maximum number of cases were in the 31-40 age group (25.21%) followed by the 41-50 age group (20.86%). 76 (66.08%) were males and 39 (33.91%) were females. 52 patients (45.21%) had concomitant diseases, out of which 15 (13.04%) were HIV positive and 21 (18.26%) were diabetic. 70 patients (60.86%) developed ADRs. The adverse drug reaction that were seen are -38 (38.76%) cases of gastrointestinal adverse drug reactions, 8 (8.16%) jaundice/hepatitis, 7 (7.14%) impaired hearing/vertigo, 21 (21.24%) central nervous system adverse drug reaction, 6 (6.12%) peripheral neuropathy, 6 (6.12%) rash and itching, 5 (5.10%) arthralgia, 3 (3.06%) renal impairment, 2 (2.04%) hypothyroidism and 2 (2.04%) blurred vision.Conclusions: Determining which population groups are affected most by ADRs can help physicians to better monitor and make an early diagnosis to reduce ADR-related morbidity and mortality.
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BACKGROUND: Anti tubercular treatment (ATT) exhibit greater level of a efficacy with a satisfactory degree of toxicity, however combination treatment may produce severe adverse drug reaction (ADR). ADR leads to decrease in patient compliance & adherence .So close monitoring of ADR & it‘s effective management needed. Objective- To study of adverse drug reactions (ADR) in tuberculosis (TB) patients registered under RNTCP and the effect of adverse drug reaction. Material & Methods- This is longitudinal (Prospective) study done during January2008 to June2009 Total 806 patients who registered in 9 PHCs, Sub District Hospital, Krishna Hospital & 6DMCs with 3 ICTCs under Karad TU as study subjects. Result & Observations - It was 513 (63.6%) patients had adverse reactions while 293 (36.35%) had no adverse reactions. Out of 513 patients 486 (60.30%)had gastritis, 33 (4.09%) had gastritis and joint pain, 49 (6.09%) had gastritis and skin rash, 62 (7.69% ) had itching, 43 (5.33%) had joint pain. Thus gastritis was being the most common adverse Conclusion- There was no any significantly association seen between ADR and gender in this study. It was observed that 147(21.4%) patients continued DOTS treatment after giving treatment for ADR, 240(34.9%) continued DOTS treatment even if they were not treated for their ADR, 301(43.8%) continued DOTS treatment after given reassurance foe ADR. Conclusion- Gastritis 480 (60.30%) was the most commonest adverse reaction seen as well as most of the adverse reactions was seen in intensive phase i.e. in first 2 months. There was not association in ADR and gender. In this study, 147(21.4%) patients continued DOTS treatment after giving treatment for ADR, 240(34.9%) continued DOTS treatment even if they were not treated for their ADR, 301(43.8%) continued DOTS treatment after given reassurance for ADR. Most of the adverse reactions were in intensive phase of treatment i.e. that in first 2 months. Gastritis was present in intensive phase as well as initial months of continuation phase treatment.
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Background: The study was conducted with the aim to evaluate the pre-treatment drug susceptibility profile and to assess the influence of drug resistance on treatment outcome among patients treated with category- II (cat- II) regimen under programme conditions.Methods: This study was conducted on 58 smear positive patients with history of previous anti-tuberculosis treatment for more than one month, comprising cases of ‘Failure’, ‘Treatment after Default’ (TAD) and ‘Relapse’. They received cat- II regimen in Chennai Corporation, RNTCP (revised National tuberculosis control programme) centers from July 2006 to September 2006 and they were monitored upto July 2007 as per RNTCP guidelines to assess the outcome of cat-II treatment by sputum smear status.Results: Male dominance (n=40) was seen in the study participants. Most common age group affected was 35-44 years (n=20). Out of 57 cases, 50.9% cases come under ‘Relapse’, 26.3% arises from ‘TAD’ and 22.8% cases were from ‘Failure’. After completion of treatment with cat-II regimen, out of 57 patients 33 patients were cured and 11 cases were into the category of failure, 10 patients were defaulted during treatment and 3 were died.Conclusions: Besides, the low treatment efficiency in MDR-TB cases, cat- II regimen was effective in sensitive and INH resistant cases.
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Background: Puerperium is of 6 weeks after delivery, when body reverts back to its original non pregnant state. This period holds its own set of medical issues with frequent occurrence of gynaecological complaints like hematoma, bleeding, painful discharge and many medical issues like pyrexia, mastalgia, coagulation disorders and depression. The management of all these problems is further complicated by consideration of lactation which prohibits use of many drugs. There are many studies available in international communities that analysed women in puerperium but the data from Indian subpopulation where most deliveries are conducted in government funded institutes is lacking. The current study was an observational single center study carried out at gynaecology department along with medicine and surgery department of a tertiary care hospital associated with a medical teaching institute for defining the epidemiological parameters of the puerperal maladies.Methods: 150 randomly selected pregnant subjects with otherwise uncomplicated pregnancies, both booked at our institute or referred at the time of delivery between January to July 2016 were included in the study. Both normal vaginal or assisted deliveries were considered irrespective of booking status. Patient not willing for consent, and patients reporting beyond 2 weeks of delivery were excluded. All patients were observed while in hospital and weekly thereafter till 6th week and detailed gynaecological, medical and psychiatric evaluation was carried out by a multidisciplinary team. Detailed evaluation of cause was carried out in all cases of pyrexia, pain or other objective symptoms and analysis of depression was done. All data were collected and analysed by spss 22.0 at the end of 6 weeks.Results: Of the 150 patients studied, 40% had caesarean delivery while 60% had normal vaginal delivery with or without episiotomy. The most common complications noted during puerperium were wound discharge (10.67%), perineal pain (10%), fever (15%) and Mastalgia & Mastitis (13%). Depression was diagnosed in 6% of the studied cases. Cause of fever was mastitis/breast abscess in 30%, Urinary tract infection in 24%, Malaria in 7% and puerperal sepsis in 12% cases, in rest of the cases the cause of fever could not be found. The puerperal complication rate was more in LSCS 22.95% as compared with vaginal deliveries 14.6%.Conclusions: Puerperium remains an important aspect of pregnancy where the nature of complications differs totally from those seen during antenatal period. Our study suggests that most important complications in puerperium are purulent discharge, perineal pain and pyrexia. Depression is a frequent occurrence in post-partum period and its early identification can benefit both maternal and child health. Fever in puerperium is fairly common Perineal infection, Breast infection, Urinary tract infection and Malaria being common causes. A vigilant multidisciplinary approach is required to optimally manage all these complications.
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Introduction: Tuberculosis is an infectious disease caused by the bacillus Mycobacterium tuberculosis. It mostly affects the lungs (pulmonary TB) and sometime affect other sites (extra pulmonary TB). The disease is spread when people who are sick with pulmonary TB expel bacteria into the air by coughing. Overall, a relatively small proportion (5–15%) of the estimated 1.7 billion people infected with M. tuberculosis will develop TB disease during their lifetime. Objective: To assess the treatment outcome of tuberculosis patients registered under Revised National Tuberculosis Control Programme (RNTCP) and to find out spatial pattern of tuberculosis patients. Materials and Methods: A retrospective record based study was conducted based on the secondary data pertaining to the patients registered at six different tuberculosis units (TU) and 29 designated microscopic centers (DMC) in Sonbhadra district during the period from 2005 to 2015. Results: Overall 85.8% were new cases and among them 80.0% were as pulmonary cases observed. Sputum conversion rate of new sputum-positive case at 2 or 3 months after treatment was 89.9%. Cure rate for new sputum-positive pulmonary TB cases was 84.9% and out of all smear-positive cases, it was 62.4%. Default among new smear-positive cases was 5.5%. Conclusion: The observed treatment success rate in form of cured and treatment completed (91.5%) reveals that the DOTs as an effective strategy for tuberculosis treatment may be classified as better alternative for area like Sonbhadra.
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Introduction: Diagnosis of pulmonary tuberculosis in sputum negative patients for acid fast bacilli ischallenging till today. It is a fact that 50-60% patients of pulmonary tuberculosis are sputum negativemicroscopically. Smear microscopy is the easiest, commonest and widely employed tool for confirmatorydiagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture forMycobacterium tuberculosis bacteria can increase the diagnostic yield by 20-40%, but it takes long duration of2-8 weeks when solid media are used or 10-14 days when radiometric system in liquid media are used. Delayeddiagnosis causes increased rate of disease transmission in the community. The role of newly introducedcartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP)is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosispatients with detection of rifampicin resistance within 2 hours only. Aims and objectives: The current study isto find out efficacy of CBNAAT in diagnosis of new sputum negative pulmonary tuberculosis patients. Thedetection of rifampicin resistance is also done in those patients. Materials and Methods: Sputum samples of100 sputum negative pulmonary tuberculosis patients were sent to District CBNAAT center in sterilized falcontube container. The CBNAAT result were analyzed. Results: Mycobacterium tuberculosis was detected inthirty one patients (31%). Not a single case was detected as resistant to rifampicin. Conclusion: CBNAAT helpsin increased case detection rate in lesser time in new sputum negative pulmonary tuberculosis patients.Rifampicin resistance was not detected in any patient.
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Detection and monitoring of adverse drug reaction was done by interviewing patients, consulting with physicians about the patient’s clinical problems, reviewing laboratory test and medical records. The data so collected was entered and analyzed using SPSS 21 software.Results: The Incidence of adverse drug reaction was observed in20.4% i.e. 21 out of 102 patients. Total number of adverse reactions developed in 21 patients were 31, with most common being GIT Nanda GS, Singh H, Sharma B, Arora A. Adverse Reactions Due to Directly Observed Treatment Short Course Therapy: An Indian Prospective Study . IAIM, 2016; 3(1):6-12.Page 7system(38.7%), followed by skin problems (29%). History of alcoholism,associated co-morbidities, pulmonary TB and DOTS treatment Category II were found to be significantly associated with occurrence of ADRs. Conclusion: The present study highlighted the importance of developing strategies to ameliorate ADRs both to improve the quality of patient care and to control TB safely. In addition, a proper educational counseling may promote more ADR reporting by patients. These strategies may improve the patient adherence to treatment and therapeutic outcome
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Background: India is the highest TB burden country in the world. In the year 2006, annual performance of revised national tuberculosis control programme (RNTCP) in India, in terms of cure rate of new smear positive patients was 84%, default rate was 6.4% while in Madhya Pradesh it was 82% and 7.6% respectively. Rewa district have poor performance as compare to national level. Non-adherence with treatment has been recognized as an important factor responsible for low cure rate and high incidence of drug resistant TB. The objective of study was to find out the compliance rate with DOTS and associated factors responsible for non-compliance in the district. Methods: The present observational study was carried out at fifteen selected DMC cum DOTS centers of Rewa district, M.P. Results: Of the 337 patients interviewed, majority of patients 270 (80.11%) complied and 67 (19.88%) did not comply to treatment. The main reasons for non-compliance were false perception of having their disease cured because they felt well with initial treatment 26 (38.81%), side effects of drugs 23 (34.33%), anxiety of loss of wages 9 (13.43%) and Migration of patients 7 (10.44%). Conclusions: Repeated counselling and motivation of noncompliant patients would be helpful to reduce noncompliance to treatment.