To Study the Culture Conversion and XDR Suspect of Cat-IV Patients in DOTS Plus Site, S. N. Medical College, Agra

ABSTRACT

BACKGROUND - Multi-drug resistant tuberculosis (MDR-TB) is an increasing health problem in India. Globally,3.5% of new TB cases and 18% of previously treated cases had MDR/RR-TB.(GLOBAL TUBERCULOSIS REPORT 2018). As per the India TB Report 2018 the estimated incidence of  MDRTB/RR in India was approximately 1,47,000.Outcome of MDR patient put on MDR regime is poor due to high cost, long duration of treatment, and various side effect of second line ATT. MATERIAL & METHOD - Study comprised patients who were diagnosed MDR by culture and DST method from RNTCP accredited lab and initiated CAT–IV treatment in D.R.TB Centre, Department of Tuberculosis & Chest Diseases, S. N. Medical College, Agra. Detailed history and pre clinical evaluation as per guideline were done and at the end of 3rd ,4th,5th  and 6th month sputum  were send for AFB staining and culture. RESULT – Out of 109 MDR patient put on CAT-IV, culture conversion at 3rd month occur in 52(47.70%)  patients, at 4th month in 58 patients (53.21%), and in 5th month 66 patients (60.55%). Out of 109 MDR TB patients 12 patients (11.01%) were found suspected XDR. CONCLUSION – MDR TB is major health problem worldwide. Due to less efficacy and more side effect of second line ATT, longer duration of treatment, MDR TB is difficult to treat even with free supply of ATT through DOTS PLUS. Close attention is needed for early diagnosis  of MDR TB , and adequate clinically monitoring of during treatment is essential.