Abstract
STUDY OF SPUTUM SMEAR AND CULTURE CONVERSION IN DRUG RESISTANT TUBERCULOSIS PATIENTS TREATED UNDER PROGRAMMATIC MANAGEMENT OF DRUG RESISTANT TUBERCULOSIS AT ACHARYA VINOBHA BHAVE RURAL HOSPITAL

Dr. Aditya Sharma, Dr. Ulhas Jadhav* and Dr. Babaji Ghewade

ABSTRACT

Introduction: Drug resistant tuberculosis in patients requires treatment for long term and has a high fatality rate. Early detection of treatment failure through sputum conversion is required to predict the outcome of the therapy. Early culture conversion is a predictor of successful treatment outcomes. Aim and Objectives: To study the maintenance of bacterial quiescence (culture negativity) with duration of treatment and effectiveness of DOTS PLUS therapy by observing sputum smear and culture conversion. Materials and methods: All the diagnosed patients of Drug Resistant Tuberculosis referred by District tuberculosis centre Wardha to Drug resistant tuberculosis link centre at Acharya Vinobha Bhave rural hospital Wardha were included In the study during the period from 01/09/2016 to 31/08/2018. Sample size of 26 patients was taken. Treatment was given as per PMDT guidelines and these patients were discharged from our hospital. Through DTO and associated staff concerned sputum culture and smear reports were followed for 3rd,4th,6th,9th and 12th months. Results: Sputum smear and culture conversion was found out to be 57.7 % after the duration of our study, in which we could follow up all the patients for one year of treatment. The default rate observed was 19.23 %. Highest default rate was observed within the first 3 months of treatment initiation (7.69 %). The main cause of the treatment default was Adverse drug reactions, most common among them was Hepatotoxicity. Diabetes mellitus and Low BMI were associated with poorer outcomes in terms of sputum conversion. Conclusion: The sputum conversion rate in our study dropped significantly when comparing the results from 3rd month and 12th month of follow up respectively. This was partly due to treatment default, mainly to Adverse drug reactions. We also found out that patients who had low BMI and Uncontrolled Diabetes mellitus were more likely to be sputum smear and culture positive during follow up. So, if the proper dietary and medical management of patients with low BMI and DM is done, treatment outcomes would be better.

Keywords: Tuberculosis, Drug Resistant Tuberculosis, Sputum conversion.


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