ABSTRACT
BACKGROUND: Drug-resistant tuberculosis is a major public health problem throughout the world and accounts for substantial morbidity and mortality rates in India, too. Early diagnosis is the corner stone of tuberculosis treatment. State-level and cluster-wise variations in drug resistance is a possibility and should be regularly checked in from time to time. MATERIALS AND METHODS: The present prospective cohort study (January 2019 to May 2022) was conducted in Darbhanga Medical College and Hospital on drug-resistant pulmonary tuberculosis patients. Sputum specimens were collected from designated centers. Rapid molecular drug-resistance testing (genotypic tests) and growth-based drug-susceptibility testing (DST) (phenotypic tests) were performed in the National Tuberculosis Elimination Program certified Laboratory. RESULTS: A total of 268 patients with drug-resistant pulmonary tuberculosis were included in the study group. The treatment outcomes revealed as cured in 100 (37.31%); treatment completed in 43 (16.04%); died in 56 (20.89%); treatment failed in 22 (8.21%); loss of follow up in 34 (12.69%); and transferred out in 13 (4.85%) drug-resistant pulmonary tuberculosis patients. Adverse events were recorded in 199 (74.25%) of the drug-resistant pulmonary tuberculosis patients. CONCLUSIONS: Drug-resistant pulmonary tuberculosis patients are a matter of concern and need to be addressed.
ABSTRACT
BACKGROUND: Drug resistant-tuberculosis (DR-TB) patients are provided universal drug susceptibility testing (UDST), anti-TB drugs for the treatment of DR-TB, nutritional support (Nikshay Poshan Yojana - the financial incentive of rupees five hundred per month for each notified DR-TB patient for the duration for which the patient is on anti-TB drugs) by the Government of India. METHODS: This retrospective cohort record-based study was conducted in DR-TB patients. Some 1095 DR-TB patients who have initiated treatment at Nodal DR-TB Centre, Darbhanga Medical College and Hospital (DMCH), Darbhanga, and continued their anti-TB drugs at home blocks were followed till their treatment outcome was known. Data were analyzed by statistical experts of DMCH. RESULTS: Treatment supporters comprised 688 (62.83%) females and 407 (37.17%) males. Different types of treatment supporters noted were accredited social health activists (ASHAs) 622 (56.80%), family members 365 (33.33%), and community health workers 108 (09.86%). Treatment outcome as transfer out was observed in 08 (1.29%), 10 (2.74%), and 13 (12.03%) cases among ASHAs, family members, and community health workers, respectively [statistically significant (p < 0.0001)]. CONCLUSION: ASHAs proved to be the best treatment supporters in comparison to both family members and community health workers for multi-drug resistant TB (MDR/RR-TB) patients.
ABSTRACT
BACKGROUND: As per WHO Global TB report (2018), 10.0 million people developed TB in 2017. India accounted for 20 % of world cases. Globally, 3.5 % of new cases and 18% of previously treated cases had MDR-TB. Corresponding figures for India are 2.8 % and 12 %. Among cases of MDR-TB in 2017, 8.5% were estimated to have XDR-TB. Drug resistant TB cases are on rise and needs planning and research for its treatment and control. MATERIALS AND METHODS: A retrospective study was conducted on MDR-TB and XDR-TB patients to evaluate social and demographic profile of these patients in Bihar. RESULTS: A total of 700 (530 males and 170 females) MDR-TB and 51 (40 males and 11 females) XDR-TB patients were analyzed, which revealed 293 (41.86 %) patients of MDR-TB and 23 (45.10 %) patients of XDR-TB in the age group of 15 to 25 years. Mean age of MDR-TB patients in this age group was 20.52 years and for XDR-TB 21.17 years. CONCLUSION: Drug Resistant Tuberculosis Control Programme should focus adequately on youth in state of Bihar, India.