Assessment of the efficacy of Directly Observed Treatment with short course (DOTS) for pulmonary tuberculosis in Sharkia governorate

BackgroundDOTS remains one of the most widely-implemented and longest-running global health interventions in tuberculosis control.Aim of the workTo evaluate DOTS strategy based on WHO guidelines on pulmonary tuberculosis in both Chest and Zagazig University Hospitals.Patients and methodsThis study was carried out at both Chest Department, Zagazig University Hospitals and Zagazig Chest Hospital, in the period from October 2008 to October 2009. One hundred and twenty patients with smear positive tuberculosis were included in this study. Group I: This group included 60 patients; 48 (80%) of them were males and 12 (20%) were females. Their ages ranged from 16 to 75 years old, with a mean age of 46.0 ± 11.1. Those patients were receiving antituberculous drugs according to DOTS guidelines suggested by the national tuberculosis control program (NTP) in Egypt (2008) at the health facility nearest to their home. Group 2: Included 60 patients, they were 52 (86.7%) males and 8 (13.3%) females, their ages ranged from 20 to 70 years old with a mean age of 48 ± 12.3. Those patients were receiving self administration therapy (SAT) by the same regimens as in Group I. All patients were subjected to; Medical history taking, Clinical examination, Routine laboratory investigation, Radiological examination, Sputum analysis by Ziehl Neelsen stain for acid fast bacilli at the time of diagnosis, at the end of initial phase, at the end of the 5th month and at the end of the course.ResultsThere were 38 patients (63.3%) cured in group I versus 20 (33.3%) in group II, with a highly significant difference between the two groups, as P < 0.005. There were 42 patients (70%) regular in receiving the treatment in group I versus 24 (40%) in group II with a significant difference between the two groups as P < 0.05. There were 6 patients (10%) defaulters in group I versus 20 (33.3%) in group II, with a significant difference between the two groups, as P < 0.05. There were 22 patients (36.7%) failed in the treatment in group I versus 40 (66.7%) in group II, with a highly significant difference between the two groups, as P < 0.005.Conclusions1 – DOTS yields more cure rate in the treatment outcome of pulmonary tuberculosis and decreases the rate of failure and defaulting. 2 – Defaulting and non-adherence of the patients could be considered as important factors for increased incidence of failure in the treatment outcome of TB either under DOTS or SAT.