Treatment interruption of tuberculosis, resulting from lack of drug supply,improper drugs regimen, ATD duration may result in the emergence of drugs resistant tuberculosis(MDR), a simple ignorance of patients/health care providers may result in this tragic incidence.
In the Pulmonology department of Al-Junaid Hospital,Jan.2002-Dec.2003, 300 newly diagnosed patients with PTBwere registered,120 (40%)were AFB smear-positive. No evidence of MDR TB of registered patients( including male/female,18-65 years age, mean age 41 years). were documented by subsequent culture and susceptibility testing. Successful treatment outcomes were documented for 67 (56%) smear-positive patients, the remaining 53(44%) patients with poor outcomes, therapy failed in 12 (23%),30(57%) defaulted while 11(20%) died. In the later 3 died in the first month, 2 with in 2nd & 6 in the 3rd month of treatment. Treatment interruption of 2-8 weeks had been observed in 35 patients with 10 (29%), interrupted treatment, during the intensive phase(1-2weeks), 14 (40%) interrupted during the continuation phase (2-4 weeks), while 11(31%) during both phases of treatment(4-8weeks). The mean duration of interruption was on an average being 3 weeks, cough fever & anemia being the harbinger of interrupted ATD. Of 40 patients having successfully completed ATD, 24(60%) had 9 months, 14(35%)had 10 months & the rest of 2(5%) had completed 11 months of scheduled ATD.
The incidence of MDR had been significantly higher amongst individuals with frequent interruptions & lack of supervised ATD therapy.
Therapeutic interruptions even of shorter durations are of :utmost importance as strict patient’s adherence consequently leads to a successful therapeutic outcome.
Chemotherapeutic interruption had been more amongst patients from remote regions, those with poor compliance even on repeated notification for ATD, also those with discontinuation of ATD on symptomatic relief with false impression of cure of infection.
S. Khan, None.