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Risk factors for new pulmonary tuberculosis patients failing treatment under the revised national tuberculosis control programme, India

journal contribution
posted on 2023-02-07, 22:58 authored by R Singla, D Srinath, Sunil GuptaSunil Gupta, P Visalakshi, UK Khalid, N Singla, UA Gupta, SK Bharty, D Behera
SETTING: Tertiary level tuberculosis (TB) institute in Delhi, India. OBJECTIVE: To study the risk factors for new pulmonary TB (PTB) patients failing treatment. DESIGN: Prospective case-control study. The profile of new PTB patients failing treatment (i.e., sputum smear- positive at 5 months of treatment) and responders under the Revised National Tuberculosis Control Programme (RNTCP) were compared and risk factors associated with treatment failure were analysed. RESULTS: A total of 42 treatment failure cases and 76 controls were enrolled in the study. The presence of cavity on chest X-ray (CXR), sputum acid-fast bacilli (AFB) smear positivity at 2 months of treatment and the number of interruptions in treatment were independently associated with failures. Among failure patients at 5 months, 17 (40.5%) had negative sputum culture for Mycobacterium tuberculosis, and only six (14.3%) had multi- drug-resistant TB (MDR-TB). When put on retreatment, patients with smear-positive, culture-negative sputum had cure rates of 88.2% compared to 28.6% among culture-positive patients. CONCLUSIONS: The presence of cavity on CXR, sputum smear positivity at 2 months of treatment and the number of interruptions of treatment are risk factors for failure. Among failures based on smear examination, the prevalence of MDR-TB is low and many patients have negative cultures for M. tuberculosis. Smear positivity at the end of treatment may not be a reliable indicator of treatment failure. © 2009 The Union.

History

Journal

International Journal of Tuberculosis and Lung Disease

Volume

13

Pagination

521-526

Location

France

ISSN

1027-3719

eISSN

1815-7920

Language

eng

Issue

4