Effect of Pre-Treatment Bacillary Load on Treatment Outcome of New Pulmonary Tuberculosis Patients Receiving DOTS under Revised National Tuberculosis Control Programme Parande A Malangori1, Tapare V.S.1, Borle P.S.1, More S.W.2, Tambe M. P., Bhattacharya Susmita3 1Associate Professor, Department of Preventive and Social Medicine, B.J. Govt. Medical College, Pune, India 2CMO cum Director, State TB Training and Demonstration Centre, Pune, India 3Professor, Department of Preventive and Social Medicine, B.J. Govt. Medical College, Pune, India Online published on 29 December, 2017. Abstract Introduction Under DOTS strategy, a high pre-treatment bacillary load may appear to be an important predictor for poor treatment outcome Purpose To find out the treatment outcome of new smear positive pulmonary tuberculosis patients with various grades of sputum smear positivity Materials & methods A retrospective record based cohort study conducted among all new smear positive pulmonary tuberculosis patients registered during period of 1st January 2015 to 31st December 2015 in a TU of Pune. Smear positive patients under study was divided into two groups as per grading of sputum AFB: Group I High bacillary cohort (sputum 3+) and Group II Low bacillary cohort (sputum 1+ and 2+ combined). Results Sputum conversion rate at the end of 2 months’ intensive phase and at the end of 3 months was significantly low in Group I as compared to Group II (p<0.001). Non adherence to treatment was significantly more among Group I in intensive as well as in continuation phase as compared to Group II (p<0.001). Unfavourable outcome was seen in 10(16.1%) and 7(2.8%) among Group I and Group II respectively (p<0.01). Odds ratio of unfavourable outcome was 6.62 (CI-2.40–18.2) among Group I as compared to Group II. Conclusion From practical point of view, it would appear that grading of sputum need not be an academic exercise but instead help pinpoint a group of patients who are likely to have unfavourable outcome oftener than others and these patients need to be closely supervised. Top Keywords DOTS, Pre-treatment bacillary load, Treatment outcome, Predictor. Top |