DOTS at a tertiary care center in northern India: successes, challenges and the next steps in tuberculosis control.

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dc.contributor.authorTahir, Mohammaden_US
dc.contributor.authorSharma, S Ken_US
dc.contributor.authorRohrberg, Duncan-Smithen_US
dc.contributor.authorGupta, Deepaken_US
dc.contributor.authorSingh, U Ben_US
dc.contributor.authorSinha, P Ken_US
dc.date.accessioned2006-05-29en_US
dc.date.accessioned2009-05-27T08:26:32Z
dc.date.available2006-05-29en_US
dc.date.available2009-05-27T08:26:32Z
dc.date.issued2006-05-29en_US
dc.description.abstractBACKGROUND AND OBJECTIVES: The past decade has seen a rapid expansion of directly observed treatment, short-course (DOTS) centers throughout India, under the guidance of the Revised National Tuberculosis Control Programme (RNTCP). While expansion has been rapid and extensive, few reports exist detailing individual DOTS centers' experiences, their challenges, and their successes. We present a brief report on the status of a DOTS center being run at a large tertiary care center in northern India for almost four years (2001-2005). METHODS: The DOTS center followed RNTCP guidelines for the evaluation and treatment of suspected TB cases. A register carrying detailed information of all patients seen at the DOTS center was kept by the senior clinician. Data from this register were extracted and analyzed for descriptive measures. RESULTS: A total of 1490 patients were evaluated. Of the 768 patients with cough, 27 per cent (211) were found to be sputum positive for acid-fast bacilli (AFB). Among patients who were initiated on anti-tuberculosis medications, cure was achieved in 92 per cent (71 of 77) of new sputum smear positive patients; treatment completion was achieved in 91 per cent (91 of 100) of extrapulmonary TB (EPTB) and 75 per cent (46 of 61) of sputum-negative pulmonary TB patients. Overall treatment success was achieved in 86 per cent (229 of 266). INTERPRETATION AND CONCLUSION: Treatment results were in keeping with the RNTCP guidelines. Tertiary care centers appear to be excellent place for education of medical students and operational research. The latter is much needed, as HIV-TB co-infection, multi-drug resistant TB, and EPTB continue to be major public health threats even in the era of DOTS.en_US
dc.description.affiliationDivision of Pulmonary and Critical Care Medicine, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.en_US
dc.identifier.citationTahir M, Sharma SK, Rohrberg DS, Gupta D, Singh UB, Sinha PK. DOTS at a tertiary care center in northern India: successes, challenges and the next steps in tuberculosis control. Indian Journal of Medical Research. 2006 May; 123(5): 702-6en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/24460
dc.language.isoengen_US
dc.source.urihttps://icmr.nic.in/ijmr/ijmr.htmen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAntitubercular Agents --therapeutic useen_US
dc.subject.meshChilden_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshDirectly Observed Therapyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNational Health Programsen_US
dc.subject.meshPractice Guidelines as Topicen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshTuberculosis --diagnosisen_US
dc.subject.meshTuberculosis, Pulmonary --diagnosisen_US
dc.titleDOTS at a tertiary care center in northern India: successes, challenges and the next steps in tuberculosis control.en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, N.I.H., Extramuralen_US
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