RESUMEN
Background: Tobacco consumption and smoking are causative factors that can create a favorable environment for tuberculosis and increase the morbidity and mortality attributed to it. Tobacco use is the leading global cause of preventable death (6 million deaths per year). This study compares the treatment outcome in pulmonary tuberculosis patients on DOTS daily regimen with respect to consumption of tobacco and smoking. Aims: 1. To study the prevalence of tobacco consumption and smoking among microbiologically confirmed new pulmonary tuberculosis patients. 2. To study the effect of tobacco consumption and smoking on the outcome of microbiologically confirmed new pulmonary tuberculosis patients. Material and Method: The prospective observational study was conducted on microbiologically confirmed new pulmonary tuberculosis patients enrolled during the first quarter of the year 2019 (i.e., from 01/01/2019 to 03/31/2019) at the four selected DMCs of Amritsar City. In total, 197 patients were included in the study depending on the inclusion and exclusion criteria. The prevalence of tobacco consumption and smoking at the start of treatment was noted and the effect on outcome was observed. Results: Prevalence of tobacco consumption and smoking was found to be 24.37% and 21.83%, respectively. In addition, 93.96% of non-tobacco consumers and 94.15% of non-smokers had favorable outcomes as compared to 83.34% of tobacco consumers and 81.4% of smokers, which is statistically significant. Conclusion: Tobacco consumption and smoking have significantly higher chances of unfavorable outcomes (loss to follow up, change in treatment regimen, and death) as compared to non-consumption and non-smoking.
RESUMEN
BACKGROUND: Inspite of the success of RNTCP in tuberculosis control in India, the problem of drug resistant forms of tuberculosis still remains untackled. The present study focuses on the prevalence of MDR-TB, pattern of drug resistance and characteristics of MDR-TB patients in district Amritsar, Punjab in north India. The programme-related aspects studied are the challenges in effective implementation of DOTS-PLUS. MATERIAL AND METHODS: A retrospective study was conducted in the month of April, 2013. The records from November 2011 to April 2013 were analysed. RESULTS: Amongst a total of 200 MDR-suspects as per the criterion A of RNTCP, prevalence of drug resistance was 22.50% in Cat I failures and 36.25% in Cat II fourth month or later positive. Out of 67 patients who were to be initiated on Cat IV (H and R resistant or R resistant), 55 patients were put on treatment. The total time taken by the patients from identification as MDR-TB cases to initiation of Cat IV regimen at DOTS-plus site was 17.89 days. CONCLUSION: The findings of the study highlight the need for early referral, rapid diagnosis and prompt initiation of Cat IV of MDR-TB cases to decrease morbidity, mortality and disease transmission.
