Initial Higher Sputum Graded Patients Treated Under Category-II RNTCP (DOTS) with Low Weight Gain Tend to Have More Relapse Rate

DOTS strategy, as recommended by the WHO after declaring tuberculosis as a global emergency in 1993, is a very important landmark in the history of tuberculosis control. Supervised, intermittent chemotherapy was found to be operationally impracticable under National Tuberculosis Control Program. Hence Cost effective strategy directly observed intermittent chemotherapy for tuberculosis control under RNTCP has been formulated and implemented. It has long been proved to be effective in various trials in India. Under DOTS strategy, the main emphasis is on diagnosing and treating sputum smear positive patients, thus the stress on sputum microscopy. The patients are categorized into two categories according to status of the disease and previous treatment history. Various published reports indicate a very high efficacy of treatment regimens with cure rates of 80-100 % under RNTCP. However follow up reports of relapse rate on patients who have completed treatment under RNTCP are very few. Relapse rate, an important indicator of success of any treatment regimen, has not been measured under program condition. Follow up study of 203 patients was done to examine the rate of relapse among sputum smear positive pulmonary tuberculosis patients who have successfully completed treatment and declared either cured or treatment completed. Majority of 21/32 (65.6 %) relapses were occurred in those who gained less than 4 kg weight gain during treatment. Further the maximum number 64 % (16/25) among Category-1 patients and 71.43 % (5/7) among Category-II patients relapsed within first 6 month of follow up period.