|IMPACT OF SHORT COURSE CHEMOTHERAPY ON THE OPERATIONAL
EFFICIENCY OF NATIONAL TUBERCULOSIS PROGRAMME
|TR Sreenivas, CV Shyamasundara, K Chaudhuri: Indian
J TB 1992, 39, 107-11.
Five districts in which short course chemotherapy
(SCC) was introduced during 1987-88 (DTP-SCC) and an equal number
of districts without an SCC programme (DTP-SR) but having comparable
new sputum examinations performance (NSE) in 1986 were selected
from the states of Gujarat and Tamilnadu. Data obtained by the monitoring
cell of the National Tuberculosis Institute (NTI) for 15 consecutive
quarters from the lst quarter of 1986 were analysed. It was possible
to study operational variables: NSE, number of pulmonary patients
diagnosed (TBP) and number of bacillary cases detected (BCASE).
While the figures of first six quarters were used to represent pre
SCC performance, those of the last six quarters depicted the post
SCC scenario. However, the trend analysis has been done using the
The growth rates of NSE, TBP and BCASE were 14.1%,
1.7% and 13.0% respectively for DTP-SCC compared with 17.0%, 5.3%
and 29% for DTP-SR. Both the DTCs and PHIs in DTP-SR showed negative
growth in BCASE, inspite of their efforts as evidenced by increase
in NSE and TBP, the introduction of SCC led to an increase in BCASE
for both DTC and PHIs. While the PHIs in DTP-SCC showed increased
efficiency in all the aspects (NSE 24.4%, TBP 19%, BCASE 16.7%),
DTCs showed decreased activity in NSE ( -2.4) and TBP (-6.6%), indicating
improvement at the periphery. Trend analysis corroborated the above
|KEY WORDS: SCC, IMPACT, OPERATIONAL EFFICACY,
|RESULTS OF TREATMENT WITH A SHORT COURSE CHEMOTHERAPY
REGIMEN USED UNDER FIELD CONDITIONS IN DISTRICT TUBERCULOSIS PROGRAMME
|K Chaudhuri, P Jagota & N Parimala: Indian J
TB 1993, 40, 83-89.
The treatment results of an unsupervised Short
Course Chemotherapy (SCC) regimen used under conditions of District
Tuberculosis Programme (DTP) are presented. The District Tuberculosis
Centre (DTC), Kolar and six of its Peripheral Health Institutions
(PHIs) formed the study area. No extra efforts except ensuring of
adequate availability of drugs at the participating centres were
made to obtain patients' compliance. In all, 584 smear positive
tuberculosis patients were diagnosed during the study period but
28.3% of the patients could not be initiated on treatment with the
chosen self administered SCC regimen -2EHRZ/6TH(EH).
Of the 382 put on treatment, only 33.2% completed
over 75% drug collections in both intensive and continuation phases.
The pattern of treatment compliance did not vary with the place
of treatment, i.e. DTC or PHI. Irrespective of treatment compliance,
nearly 72-77% of the patients attained smear negative status at
the end of the period of treatment, there being no difference between
PHI and DTC. However, deaths were higher in the PHI patients. This
could be attributed to a significantly higher proportion of aged
patients taking treatment at PHI than at DTC. Considering death
as an unfavourable outcome, overall favourable response was 65.9%.
Patients with drug sensitive bacilli had a higher rate of culture
negativity (70%), as compared to those with drug resistant bacilli
(48%). It was concluded that unsupervised SCC could give encouraging
results in a DTP setting, provided adequate drug supply was ensured.
|KEY WORDS: SCC, CONTROL PROGRAMME, OPERATIONAL