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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
DOTS for TB relapse in India: A systematic review
1Department of Public Health, Indian Institute of Public Health, Gandhinagar, India.
Lung India : Official Organ of Indian Chest Society
|May 26, 2012
Summary
Tuberculosis relapse rates in India are high, nearly 10%, with most cases occurring within six months post-treatment. Risk factors include irregular medication, initial drug resistance, smoking, and alcoholism.
Area of Science:
- Public Health
- Infectious Diseases
- Tuberculosis Research
Background:
- The Revised National Tuberculosis Control Program (RNTCP) in India faces a high percentage of smear-positive re-treatment tuberculosis (TB) cases.
- Reasons for re-treatment include disease relapse, treatment failure, and default, with no post-treatment follow-up by RNTCP to assess relapse.
- High treatment costs and disease transmission potential necessitate understanding re-treatment drivers for program success.
Purpose of the Study:
- To systematically review existing literature and gather evidence on TB recurrence after successful standard short-course chemotherapy under Directly Observed Treatment, Short-course (DOTS) guidelines in India.
Main Methods:
- A systematic literature search was conducted across multiple databases (Medline, Cochrane, Embase) and reference lists.
- Inclusion, exclusion, and quality assessment criteria were applied to filter the initial 255 papers.
- Seven studies were ultimately included in the final review.
Main Results:
- India exhibits a high TB relapse rate, approximately 10%, exceeding international figures.
- The majority of relapses occur within the first six months after treatment completion.
- Identified risk factors for relapse in India include irregular drug intake, initial drug resistance, smoking, and alcoholism; sex and weight were not significant factors.
Conclusions:
- The high relapse rate in India underscores a significant challenge in TB control.
- Relapsed TB cases respond to treatment, but less effectively than new cases.
- Current DOTS Category 2 treatment may be insufficient for re-treatment TB patients, suggesting a need for revised treatment protocols.
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