RESUMO
Setting: Revised National Tuberculosis Control Programme emphasizing on DOTS in the metropolitan city of Bangalore. Objective: 1) To evaluate the treatment outcome of new smear positive patients supported with pre and post-treatment bacteriological profile 2) To assess their bacteriological and clinical status two and half years after treatment initiation. Design: A prospective cohort study of 271 new smear and culture positive patients initiated on Cat I from April to December 1999 and followed up till treatment outcome and 21/2 years thereafter. Results: Treatment success (cured and treatment completed) of the study group was 67.9% as 24.7% patients defaulted from treatment. Treatment failures and deaths during treatment were 5.2% and 2.2% respectively. Initial drug susceptibility status did not influence the treatment outcome of the study group except in six patients, who were multi-drug resistant. The development of drug resistance during treatment was seen in 1.3%. The proportion of bacteriological positivity and mortality during follow up was significantly higher among patients who defaulted from treatment. Relapses during the intervening period were 11.4%. Conclusion: Fully intermittent CAT I regimen was effective in programme conditions, irrespective of the pre-treatment drug susceptibility status. Treatment success of the cohort was vitiated by a high proportion of defaults in a metropolitan city, where the programme was recently implemented. The study findings underscore the importance of strict adherence to the programme guidelines for successful treatment completion and a lasting cure.