Tuberculosis ‘retreatment others’: profile and treatment outcomes in the state of Andhra Pradesh, India
Abstract:SETTING: The Government of India's Revised National Tuberculosis Control Programme (RNTCP), Andhra Pradesh, South India.
OBJECTIVES: To study the basic characteristics and treatment outcomes of tuberculosis (TB) patients classified as ‘retreatment others’ and compare their treatment outcomes with smear-positive retreatment TB cases (relapse, failure, and treatment after default [TAD]).
DESIGN: Retrospective record and report review of a patient cohort (n = 1237) registered as ‘retreatment others’ under the RNTCP from July to September 2008.
RESULTS: Of 1009 patient records of ‘retreatment others’ reviewed, 674 (67%) were males, 892 (88%) were aged 15–64 years, 847 (84%) were pulmonary sputum smear-negative, 843 (84%) had unknown human immunodeficiency virus (HIV) status and 55 (5.5%) were HIV-positive. All patients were treated with the RNTCP intermittent (thrice weekly) retreatment regimen. Eighty per cent were successfully treated (cured plus treatment completed). Successful outcomes were higher in females (84%), in patients with extra-pulmonary TB (87%) and in HIV-negative patients (87%). The treatment outcomes were significantly better for ‘retreatment others’ (P < 0.05) than among the sputum smear-positive retreatment cases (78% for relapses, 59% for failures and 73% for TAD).
CONCLUSIONS: ‘Retreatment others’ were predominantly sputum smear-negative TB, with significantly better treatment outcomes than among smear-positive retreatment patients. Future studies may assess the accuracy of the diagnoses and factors contributing to the occurrence of ‘retreatment others’.
Document Type: Regular Paper
Affiliations: 1: Center for Operations Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; The Union, South-East Asia Regional Office, New Delhi, India 2: Office of the World Health Organization Representative in India, New Delhi, India 3: Impact Health Solutions, Hyderabad, Andhra Pradesh, India 4: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India 5: State TB Office, Directorate of Health, Government of Andhra Pradesh, Hyderabad, India 6: Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India 7: International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India 8: Center for Operations Research, International Union Against Tuberculosis and Lung Disease, Paris, France
Publication date: January 1, 2011
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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