A study on co-morbidities and treatment outcome based on updated definitions among tuberculosis patients registered at a tuberculosis unit, Bangalore
Keywords:Tuberculosis, Comorbidity, Treatment outcome, Tuberculosis unit
Background: Tuberculosis remains one of the world‘s deadliest communicable diseases and a major public health problem and is a most common opportunistic infection in people living with HIV. The treatment outcome of Tuberculosis is influenced by numerous factors of which presence of co-morbidities is one of the factors. The present study was done with following objectives, to assess the proportion of co-morbidities and treatment outcome of the Tuberculosis cases registered for DOTS treatment at the Tuberculosis unit.
Methods: A Descriptive study was conducted at a Tuberculosis Unit in Bangalore with 80 subjects selected by purposive sampling satisfying inclusion & exclusion criteria. Data was collected using a pretested semi structured proforma administered to all the study subjects by trained investigators. Data regarding socio demographic profile, profile of tuberculosis, medical co-morbidities which the subjects were suffering were collected and these patients were followed up till their treatment completion and outcome of treatment was given based on new WHO definitions.
Results: The present study showed that, 38 (47.50%) of the study subjects had one or the other comorbidities with chronic obstructive pulmonary disease being the most common 18(22.5%) followed by Diabetes 13(16.25%). On determining the treatment outcome of the study subjects the overall treatment success rate was 86.25% which included the cured and treatment completed subjects. However there was no statistically significant (p = 0.614) association between treatment success and presence of comorbidity.
Conclusions: The cure rate among the tuberculosis patients, following DOTS therapy was found to be slightly less than the RNTCP standards.
WHO. Global Tuberculosis report 2015. Available from: http://apps.who.int/iris/bitstream/10665/
/1/9789241564809_eng.pdf?ua=1 Accessed on 10 January 2017.
Park K. Park’s textbook of preventive and social medicine. 23rd edition. Jabalpur: M/s Banarsidas Bhanot. 2015;176(202):427-30.
Ben JM, Knut L, Stephen DL, Giovanni BM, Peter M, Philippe G, et al. Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts. The Lancet Infectious Diseases 2013;13(5):436–48.
Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C. Prevalence of Diabetes and Pre-Diabetes and Associated Risk factors among Tuberculosis Patients in India. PLoS ONE. 2012;7(7):46502.
Central TB Division. TB India 2012 Annual status report 2014. Available from http://www.tbcindia.
nic.in/showfile.php?lid=3141 Accessed on 15 February 2017.
WHO. Definitions and reporting framework for tuberculosis - 2013 revision; Available from: www.who.int/iris/bitstream/10665/79199/1/9789241505345_eng.pdf Accessed on 2 February 2017.
WHO. Global Tuberculosis report 2016. Available from: http://apps.who.int/iris/bitstream/10665/
/1/9789241565394-eng.pdf?ua=1 Accessed on 3 February 2017.
United Nations. Sustainable development goals. Available from: http://www.un.org/sustainable
development/health/ Accessed on 8 January 2017.
WHO. The end TB strategy [Online]; Available from: http://www.who.int/tb/post2015_strategy/en/ Accessed on 2 January 2017.
Dnyaneshwar MG, Rahul CB, Harsha MS. A study of socio-demographic profile and treatment outcome of tuberculosis patients in an urban slum of Mumbai, Maharashtra. Indian J Basic Appl Med Res. 2014;4(1):50-7.
Balakrishnan S, Vijayan S, Nair S, Subramoniapillai J, Mrithyunjayan S, Wilson N, et al. High Diabetes Prevalence among Tuberculosis Cases in Kerala, India. PLoS ONE. 2012;7(10):46502.
Raghuraman S, Vasudevan KP, Govindarajan S, Chinnakali P, Panigrahi KC. Prevalence of Diabetes Mellitus among Tuberculosis Patients in Urban Puducherry. North Am J Med Sci. 2014;6(1):30-4.
Jethani S, Kakkar R, Semwal J, Rawat J. Socio Demographic Profile of Tuberculosis patient: A hospital based study at Dehradun. Natl J Community Med. 2014;5(1):6-9.
Gupta S, Shenoy VP, Mukhopadhyay C, Bairy I and Muralidharan S. Role of risk factors and socio-economic status in pulmonary tuberculosis: a search for the root cause in patients in a tertiary care hospital, South India. Tropical Med & Int Health. 2011;16:74–8.
Masthi NR, Rajanna MS, Parasuramalu BG. A study on the effectiveness of DOTS on tuberculosis patients treated under RNTCP. Indian J Public Health. 2006;50(1):55-7.
Joseph N, Nagaraj K, Bhat J, Babu R, Kotian S, Ranganatha, et al. Treatment outcomes among new smear positive and retreatment cases of tuberculosis in Mangalore, South India – a descriptive study. Australasian Medl J. 2011;4(4):162–7.