Treatment of tuberculous pleural effusion patients and their satisfaction with DOTS - 1½ year follow up.
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Date
2004-10
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Abstract
Background: Under the Revised National Tuberculosis Control Programme, patients who are sputum negative after 3
smear examinations are subjected to radiological examination after they fail to respond to a course of antibiotics for a
period of two weeks. Those showing radiological evidence of pleural effusion are examined physically and investigated
further by tuberculin testing and diagnostic aspiration. Those confirmed to be suffering from tuberculous pleural effusion
by naked eye examination, biochemical tests and cytology of pleural fluid are given a fixed schedule of drugs. The
treatment is stopped after six or eight months as per category, and outcome is reported as “Treatment Completed”.
Many a time, patients question the validity of stopping treatment without radiological examination. Physicians treating
are also at times not confident themselves and often fail to reassure such patients. Presence of residual symptoms in such
patients before stopping treatment creates further uneasiness among the treating physicians.
Methodology and Results: A study carried out among 58 patients of TB pleural effusion, of which 36 (62.1%) could be
followed for a period of 1½ years, revealed that 63.9% were satisfied with the DOTS policy of stopping treatment
without x-ray at the end of treatment whereas 36.1% expressed dissatisfaction with this policy. As many as 16.7% even
got their x-rays elsewhere before stoppage of treatment, for their own satisfaction.
Conclusion: The 1½ year follow up revealed only one case of relapse i.e. a relapse rate of 2.8% after DOTS therapy. Almost
all (97.2%) were, however, satisfied with the medicines dispensed under DOTS.
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Keywords
Pleural effusion, DOTS
Citation
Dhingra V K, Rajpal S, Aggarwal Nishi, Aggarwal J K. Treatment of tuberculous pleural effusion patients and their satisfaction with DOTS - 1½ year follow up. Indian Journal of Tuberculosis. 2004 Oct; 51(4): 209-212.