Publication:

Analysis of drug resistant cases of pulmonary tuberculosis with special reference to causes

Background Despite advancement of newer diagnostic tools and medicine Drug resistant tuberculosis (DRTB) is a challenge which cannot be eliminated without public participation. This study was designed to know etiology of the drug resistant pulmonary tuberculosis cases.

Methods Prospective observational study was undertaken among adult patients in a tertiary care hospital 50 patients were studied and analyzed, all patients who were drug resistant either mono or poly from Revised national tuberculosis control programme (RNTCP) accredited lab were included in the study. Factors leading to resistance were analyzed.

Results Of the 50 patients included in this study majority were male 72%, 68% rural population, 34% were daily wedge worker and 14% were farmer. 78% patients of study group had income <50,000 per annum or dependent to others, associated comorbidities were alcoholic cirrhosis (18%), diabetes mellitus (16%), pyothorax (16%) and hepatic disorder (12%). Cause of default included side effect 26%, longer duration 34%, feeling well (26%), social stigma (12%), financial problem in (20%), poor supply of anti-tubercular drugs (8%) and negative attitude of drug provider (6%).

Conclusions Poor education lead to less awareness about tuberculosis its diagnosis and adequate treatment, financial crisis leads to early termination in non-Dots. Drug default was most important factor for drug resistance. RNTCP provides free medication by DOTS leading to less default and early diagnosis of DRTB.