Sputum Status of Sputum Positive Pulmonary Tuberculosis Patients who have Completed Category I ATT under Dots Treatment

BACKGROUND : DOTS remains the cornerstone in global efforts towards tuberculosis control. In India DOTS based guidelines given by RNTCP remains the standard of care for treatment of tuberculosis. New smear positive patients treated under RNTCP programme have a cure rate of 88% on completing treatment. AIMS & OBJECTIVES : To assess the bacteriological status of patients after one year of completion of primary chemotherapy under new smear positive category in RNTCP. To assess the effectiveness of cure obtained in that regimen and factors associated with increased chance of relapse. METHODS : The study is a prospective study. New smear positive patients who have registered under DOTS programme in the period October 2011 to March 2012 and declared cured are selected in two zones around Stanley medical college. Patients with immunosuppressive illness were excluded from the study. Their current sputum bacteriological status is assessed by sputum smear examination and culture in a spot sputum specimen. Risk factors associated with relapse are also evaluated by means of questionnaire, clinical examination, biochemical test, radiological assessment. Patients who are bacteriologic ally active were started on category II as per RNTCP norms. The sampling method is non probability sampling-convenient sampling. Radiological assessment intended in the protocol was not done during the study. RESULTS : Sputum AFB culture of the 49 patients showed positive culture in three patients. The relapse of pulmonary TB among patients who have completed ATT under RNTCP is 6 % at the end of one year. One out of three patients revealed SH resistance. CONCLUSION : Evaluation of primary resistance prior to treatment may help in avoiding future relapses