Mir Azam Khan, Anila Basit, Arshad Javaid, Muhammad Atta-ur raham Adnan, Fahad Ahmad, Noman Khan, Afaq Khattak, Hassan Sajjad, Muhammad Awais Khattak.
Outcome of community based therapy of multi drug resistant tuberculosis patients treated in a tertiary care hospital of Khyber Pakhtunkhwa.
Pak J Chest Med Jan ;20(3):81-5.

OBJECTIVES: The objective of this study was to determine the treatment outcome of MDR-TB patients in a tertiary care hospital that acts as provincial reference point for MDR TB in Khyber Pakhtunkhwa province of Pakistan SETTING: All cases of MDR-TB registered at Lady Reading Hospital Peshawar from October 2008 to December 2011 prior to the implementation of a formal Programmatic Management of Drug Resistant TB (PMDT) by National TB Control Programme (NTP). METHODOLOGY: It was a cross sectional study to find out the outcome of MDR TB patients who received ambulatory community based treatment. Patients were provided with free drugs only and no other social or travel support was available due to lack of resources. Smear microscopy was available free of cost whereas sputum culture sensitivity was not. No tools for strict supervision and ensuring compliance were available except for a volunteer treatment supporter and contact by mobile phones. RESULTS: 341 MDR-TB patients were registered during the period of the study out of which 145 (42.8%) were male and 196 (56.2%) were females. 221(64.8%) patients were between 9 - 30 years, 113 (33.1%) were between 31-60 years and 7 (2.1%) patients were above 61 years of age. The treatment outcome of the registered patients was that 134 (39.3%) patients completed their treatment, 80(23.5%) were cured, 70 (20.5%) died during the treatment, 50(14.7%) defaulted and 7(2.1%) were transferred out during the treatment. CONCLUSION: Community based outpatient treatment of multidrug-resistant tuberculosis can be an effective strategy. High default rate of 14.5 % suggests that MDR TB requires a strong system for treatment supervision. Compliance with therapy can’t be sustained if the supervision mechanisms are weak.

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