COMPARISON OF TREATMENT OUTCOME OF TUBERCULOSIS BEFORE AND AFTER THE INTRODUCTION OF DAILY DOTS IN TB CLINIC AT LADY READING HOSPITAL PESHAWAR

Abstract

Background and Objectives: Almost one third of the world‟s population is infected with the tuberculous bacilli. Effective treatment of tuberculosis requires adherence to treatment with multiple drugs for minimum of 6 months. WHO DOTS-strategy was launched in 1993 to improve treatment adherence and cure rates.This study is aimed to compare TB treatment and outcomes before and after the introduction of daily directly observed therapy (DOTS).Methods: The study employed a retrospective record review comparative study design and was conducted at the TB clinic of Pulmonology department of Lady Reading Hospital Peshawar. We compared treatment outcomes among all TB patients treated for pulmonary and extra pulmonary tuberculosis in the TB clinic from 2001 through 2006 with 2001 to 2003 and 2004 to 2006, before and after DOTS implementation respectively.Results: The study included 1235 cases with 867 patients before and 368 after introduction of DOTS. There were 631 (51.1%) males and 604 (48.9%) females. Mean age was 34.01 years (+19.717 SD). Before DOTS the cure rate was only 48.61 % which rose to 94.82% after DOTS. The proportion of treatment completion increased from 75.14 % before DOTS to 99% after the introduction of DOTS. The default rate which was initially 19.83%, declined toless than 1 % after daily DOTS. The improvement in treatment outcomes after the implementation of DOTS strategy was statistically significant (p <0.05).Conclusion: Directly Observed Treatment Short course strategy for the treatment of tuberculosis is more effective and have the greatest success in improving tuberculosis treatment outcomes.