Assessment of Success Rate of Directly Observed Treatment Short-Course (DOTS) in Tuberculosis Patients of South India

    Published on:January 2019
    Journal of Young Pharmacists, 2019; 11(1):67-72
    Original Article | doi:10.5530/jyp.2019.11.14
    Authors:

    Ramakrishna Prudhivi1*, Siva Reddy Challa2, Basaveswara Rao MV3, Veena G4, Bhaskara Rao N5, Hema Manogna Narne6

    1Department of Pharmacy Practice, Faculty of Pharmacy, Krishna University, Machilipatnam- 521001, Andhra Pradesh, INDIA.

    2Department of Pharmacology, KVSR Siddhartha College of Pharmaceutical Sciences, Siddhartha Nagar, Vijayawada-520010, Andhra Pradesh, INDIA.

    3Department of Chemistry, Faculty of Pharmacy, Krishna University, Machilipatnam-521001, Andhra Pradesh, INDIA.

    4Department of Pharmacology, Faculty of Pharmacy, Krishna University, Machilipatnam-521001, Andhra Pradesh, INDIA.

    5Department of Tuberculosis and Chest Diseases, Guntur Govt. ID Hospital, Guntur-522002, Andhra Pradesh, INDIA.

    6Department of Pharmacy Practice, Hindu College of Pharmacy, Guntur-522002, Andhra Pradesh, INDIA.

    Abstract:

    Objective: To assess the success rate of DOTS for tuberculosis patients and the secondary objective was to identify the factors associated with unsuccessful treatment outcome. Methods: A retrospective study was conducted to review the medical records of patients (n = 1113) registered at the Directly Observed Treatment Short-Course (DOTS) clinic of Government Infectious Disease (Govt. ID) Hospital, Guntur, India. Multivariate logistic regression model was used to determine the factors associated with the treatment success rate. Results: The overall mean success rate of TB patients was found to be 82.8%. Treatment success rate (TSR) was steadily increased across the years from 73.9% in 2015 to 84.3% in 2016 and 88.9% in 2017 while the death rate was steadily decreased from 11.2% in 2015 to 6.25% in 2016 and 4.33% in 2017. Risk factors significantly associated with unsuccessful treatment outcome were found to be HIV positive (P<0.001), smear negative (P<0.001), all retreatment cases (P<0.001), smoking (P=0.008), and alcoholism (P=0.019). Smear positive patients had lower death rate (3.9% vs. 10.1%; P < 0.001) and failure rate ((2.6% vs. 8.7%; P < 0.001) compared to smear negative patients. Patients tested HIV positive had seen significantly unfavorable outcomes in death rate (OR= 9.17, 95% CI=5.31-15.83; P < 0.001) and treatment failure (OR=13.3, 95% CI= 7.31-24.17; P < 0.001). Conclusion: Implementing the DOTS strategy proved the satisfactory success rate in the South Indian hospital across three years. The unsuccessful treatment outcome was significantly associated with gender, HIV status, re-treatment, smear negative, smoking and alcoholism.

    Key words: Directly observed treatment short-course, Retrospective study, Risk factors, Treatment success rate, Tuberculosis.

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