Treatment outcome of new smear positive patients of pulmonary tuberculosis treated under directly observed treatment, short-course in a rural tertiary care hospital of a hilly area

Background: Tuberculosis is one of the world’s most common causes of morbidity and mortality. The directly observed treatment, short-course (DOTS) Strategy aims to improve patient adherence to treatment and thereby prevents development of drug resistance.  Aims and Objectives: To study the treatment outcome in new smear positive patients of pulmonary tuberculosis treated under DOTS at DR. RPGMC Kangra at Tanda, H.P. Methods: A prospective observational study was conducted over duration of seven months in Dr. RPGMC Kangra at Tanda, Himachal Pradesh, India. A total of 130 new smear positive (NSP) patients of pulmonary tuberculosis (PTB) were enrolled during study period after taking informed consent. Patients were started on category I and were followed till the completion of DOTS. Treatment outcomes were recorded as per RNTCP guidelines. Results: Out of total 130 patients, 109 (83.8%) patients were cured, 14(10.7%) patients died, 2 (1.6%) patients treatment completed, 2(1.6%) patients defaulted, 2 (1.6%) patients were treatment failure and  in 1(0.7%) patient treatment regime was modified due to severe hypersensitivity reaction with HRZE. He was put on HES for one year. The mean weight ±SD was 44.5±3.53 kg at the time of start of treatment which increased to mean of 50.6±2.97 kg at the end of treatment. There was an average increase of 6.08±1.12 kg weight at the end of treatment. This was statistically significant and was evenly distributed in all age groups. Conclusions: The high cure rate and less default rate ensures that the DOTS therapy is highly effective and safe and also the DOTS program is running successfully in this rural hilly area. The increase in weight at the end of treatment was found to be strongly associated with favourable treatment outcome (p<0.05). And also furthermore it may be concluded that increased weight can also be included as one of the criteria for the favourable treatment outcome.