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ABSTRACT | Full Text Pdf

Objectives: To assess success rate and default rate of patient centered treatment of tuberculosis under programmatic condition and compare with DOTS strategy of treatment of tuberculosis.

Introduction: Tuberculosis is a common problem in Pakistan and most of the patients are from low socio-economical group. The facility of health care is poor and most of the patients are not getting chance to visit health care facility on daily basis. The strategy of DOTS needs daily observation of therapy for tuberculosis which is difficult for most of the patients. There was trial of Patient Centered treatment done successfully in Tanzania with good success results comparable to DOTS. The idea was taken from that study and the choice was given to the patients to visit health care facility on daily basis or taking home medications with treatment supporter of their choice.

Material and Method: This prospective cohort hospital based study was conducted in two teaching hospitals of Karachi. The total numbers of patient were 456. The patients with multi drug resistant tuberculosis (MDR) or patients who were transferred out were excluded. The choice of treatment supporter was given to the patient either they can have the option of the treatment support by health worker or family member. Almost all patients had taken the choice of home treatment with monthly delivery and treatment supported by their family members. The data was taken on Performa with signs, symptoms and laboratory investigations. The data was analyzed, and treatment outcome was presented according to WHO definitions.

Result: Out of 456 patients, 351 patients were compliant to the treatment and102 patients were default. The mortality rate was 0.66% (n=3). The success rate was 77.34% and default rate was 22%.

Conclusion: The success rate in our study was not same as WHO target for DOTS strategy but it was better than the other study conducted in same population under DOTS strategy. The study concluded that patient centered treatment of tuberculosis patient is an alternate option for those patients who cannot visit there health care facility on daily basis.

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