Venugopal K, Sreelatha P R, Philip Sairu, Kumar Vijay
Health Services, Government of Kerala.
Indian J Tuberc. 2008 Oct;55(4):199-202.
Effectiveness of intermittent Short Course Chemotherapy for Neuro Tuberculosis has not been well studied. There are only few reported studies on this issue in the world literature under filed conditions. Neurologists all over India are reluctant to accept Directly Observed Treatment Short course for neuro tuberculosis since its introduction in India.
Assessing effectiveness of Revised National TB Control Programme (RNTCP-DOTS) regimens among neuro tuberculosis patients registered under the programme.
All the neuro tuberculosis patients referred to RNTCP for treatment were included in the study. Study population included only those patients diagnosed at higher centre and referred to RNTCP during the period Jan - Dec 2002, Alappuzha District. Diagnostic Algorithm as per RNTCP guidelines was strictly followed and treatment outcome and follow-up status were taken from tuberculosis register. No pediatric age group was included in the study.
A total of 32 cases registered for DOTS regimen were included in the study, of whom 29 completed the treatment and all were asymptomatic at the end of treatment (85%). All patients received treatment as DOTS, but only 70% received actual DOTS. All patients were given nine months intermittent regimen as per RNTCP guidelines. Five patients died during the treatment (14%). This result shows that DOTS under field programme conditions are efficient in curing Neuro Tuberculosis.
Good result was obtained with intermittent short course chemotherapy under programme conditions in neurotuberculosis.
间歇短程化疗对神经型结核病的有效性尚未得到充分研究。在世界文献中,关于这一问题在实地条件下的报道研究很少。自直接观察治疗短程疗法引入印度以来,印度各地的神经科医生都不愿接受将其用于神经型结核病的治疗。
评估在该项目登记的神经型结核病患者中,修订后的国家结核病控制项目(RNTCP - DOTS)方案的有效性。
所有转诊至RNTCP接受治疗的神经型结核病患者均纳入研究。研究人群仅包括那些在高级中心被诊断出并于2002年1月至12月期间转诊至RNTCP的患者,地点在阿拉普扎区。严格遵循RNTCP指南中的诊断算法,治疗结果和随访状态取自结核病登记册。研究未纳入儿童年龄组。
共有32例登记接受DOTS方案治疗的患者纳入研究,其中29例完成治疗,治疗结束时所有患者均无症状(85%)。所有患者均接受了DOTS治疗,但只有70%的患者接受了实际的直接观察治疗。所有患者均按照RNTCP指南接受了九个月的间歇治疗方案。5例患者在治疗期间死亡(14%)。这一结果表明,在实地项目条件下,DOTS在治愈神经型结核病方面是有效的。
在项目条件下,间歇短程化疗对神经型结核病取得了良好效果。