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 whole data.

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 findings.

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.