Post treatment sequelae of multi-drug resistant tuberculosis patients

Sequelae of patients treated for multi-drug resistance tuberculosis (MDR-TB) remain unknown.

To assess the clinical, bacteriological, radiological and functional status of MDR-TB patients after completion of treatment.

In a cross-sectional study, MDR-TB patients who had initiated standardized, community based therapy from January 2002 to December 2006 at Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases were investigated for their current clinical, bacteriological, radiological and functional status.

Between January 2002 to December 2006, 130 patients initiated treatment, of whom 24 died. Among rest 106 patients, 63 (59%) patients could be traced: 51 were currently alive while 12 had died. The 51 alive patients had completed a mean (+/- S.D.) post treatment period of 24 +/- 14.7 months ranging from 6 to 63 months before being enrolled in the study. Among currently alive patients who could be investigated, 78% had persistent respiratory symptoms; 98% had residual radiological sequelae with 40% having far advanced involvement. Abnormal Pulmonary Function Tests were observed in 45 (96%) patients with predominantly mixed type of ventilatory abnormality in 31 (66%) patients, while 9 (19%) had pure restriction and 5 (11%) had pure obstruction. None of the patients was found to be bacteriologically positive.

Current study confirms the efficacy of the standardized regimen as none of the patients was bacteriologically positive on follow up. However, after completion of treatment significant number of cured MDR-TB patients are left with residual symptoms, abnormal X-ray chest and impairment of lung functions. These issues need to be addressed as a part of comprehensive management of MDR-TB patients under national programme.