Effect of Disease Related Variables on Treatment Outcome Under DOTS.

ABSTRACT

The study was undertaken to assess the effect of various disease related variables on treatment outcome of patients treated under Directly Observed Treatment Shortcourse (DOTS) chemotherapy. The objective of the study is to identify the factors which affect treatment outcome and are responsible for default. This Cross sectional study was carried out at three TUs (Tuberculosis Unit) of Agra city, Uttar Pradesh, India. Two DMCs (designated microscopy centers) were selected randomly from each TU. All the patients from the DOTS centers under these DMCs registered during January to December 2007 were included in the study until the sample size of 900 patients was complete. Treatment cards of these patients were obtained from their respective DMCs after their outcome had been recorded. Chi-square test was used for statistical analysis. 71.6% patients had favorable outcome while 15.1% defaulted. Defaulter were more among category-II (26.4%), pulmonary cases (18.2%) and retreatment cases (28.4% among treatment after default, 18.8% among failure and 42.9% among relapse cases), while 19.4% & 18.3% of patients among sputum positive & negative patients defaulted. Deaths were also more among pulmonary (8.0%), category II (12.3%) & treatment after default cases (11%). Favorable outcome was observed among 80.4% of new patients, 72.8% of category I patients and 85.7% of category III patients. 83.5% of patients with extra pulmonary disease had favorable outcome, while only 67.4% of pulmonary TB patients had favorable outcome. Present study concludes that default to treatment is more among category II patients, retreatment cases and patients with pulmonary disease.