RESUMEN
Considering tuberculosis as one of the resurgent disease, WHO started a directly observed therapy short course "DOTS" as a new strategy in Africa. Egypt began to adopt this strategy since 1996
Aim of the work: This study aimed to explore the pattern of pulmonary tuberculosis at Zagazig district [Sharkia Governorate] after DOTS implementation, as well as study some risk factors associated with the disease and those associated with uncure
Subjects and Methods: A follow-up study for all diagnosed pulmonary tuberculosis at Zagazig district [2003] was performed. Patients were followed up till completion of DOTS. Data was collected through questionnaires for patients and physicians, investigations and clinical examinations, as well as records review for the number of cases and their outcomes since 1990
Results: Prevalence of pulmonary tuberculosis showed a marked decline at the years 1996, 1997 and 1998 followed by a gradual rise at 1999 and 2000, then an unstable decline was noticed till the study year 2003. Cure rate showed a continuous rise since DOTS application [1996]. The majority of patients were of working age, males, urbans, married and of moderate socio-economic level. Smoking habit was found among 66.7% of them. Heavy Goza smokers represented 54.1% of Goza smokers. Nacrotics and diabetics were found among 20.8% and 25.0% of patients respectively. Vast majority of patients considered this disease as a stigma. A good percentage of patients >60% had a correct knowledge about the disease risk factors. DOTS succeeded in cure of 77.1% of patients while failed in 8.3% of them. The remaining percentage were defaulters [12.5%] and died [2.1%]. Patients conditions [general, local, chest, radiological and bacteriological] showed a significant improvement after DOTS, P < 0.00. Patients with high socio-economic level, diabetics and those who were categorized as relapsed and ttt failure, besides narcotics and high age patients were significantly found among the uncured group, [P<0.05]
Conclusions and Recommendation: DOTS is a successful strategy for TB control. Patients with high age> 40 years, relapsed and ttt failure, diabetics, narcotics and those of high socio-economic level should have a special program of monitoring throughout DOTS implementation