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一项关于在直接观察治疗下的短程化疗(DOTS)方案中,对新涂阳肺结核病例在第1、2和3个月每月进行痰菌转阴情况的研究。

A study of sputum conversion in new smear positive pulmonary tuberculosis cases at the monthly intervals of 1, 2 & 3 month under directly observed treatment, short course (dots) regimen.

作者信息

Bawri S, Ali S, Phukan C, Tayal B, Baruwa P

机构信息

Post Graduate, Deptt. of Medicine, Gauhati Medical College, Guwahati, Assam.

出版信息

Lung India. 2008 Jul;25(3):118-23. doi: 10.4103/0970-2113.44122.

Abstract

AIMS AND OBJECTIVES

To determine sputum conversion rate at monthly intervals of 1st, 2nd and 3rd month in new smear positive cases (cat-1) under treatment under RNTCP.

MATERIAL AND METHODS

The study was conducted at DOTS Center, Gauhati Medical College and Hospital; Guwahati between July 2005 to June 2006.The study is a prospective study and consists of 100 cases of new smear positive pulmonary tuberculosis cases (category 1) irrespective of age and sex.

RESULTS AND OBSERVATIONS

The age & sex distribution of 100 patients showed that majority of the patients (74%) belonged to 2nd, 3rd and 4th decades & 75% were males and 25% were female with male to female ratio 3:1 respectively. The chest x-ray of 100 Smear Positive patients shows that only 60 (60%) patients had x-ray evidence of pulmonary Koch. In the present study, sputum conversion i.e. from smear positive to smear negative at the end of the 1st month is 71%, at the end of 2nd month is 84% and at the end of 3rd month is 92%. SUMMARY #ENTITYSTARTX00026;

CONCLUSION

In conclusion, the overall sputum conversion rate under Directly Observed Treatment, Short Course (DOTS) chemotherapy in 100 sputum smear positive Pulmonary Tuberculosis in DOTS centre, Gauhati Medical College & Hospital was 92%.The chest x-ray evidence of pulmonary Koch in 100 patients is 60%.The sputum conversion at the end of 1st month is 71%, at the end of 2nd month it is 84% and at the end of 3rd month the same is 92%. In the present study, the infectivity decreases from the baseline with significant P value for sputum conversion of 3+, 2+ and 1+ sputum positivity. Directly Observed Treatment is an effective intervention for improving adherence to tuberculosis treatment programme in a resource-poor country. A significant decrease in conversion rate was observed with the initial high grade smear positive cases. More Prospective studies on larger number of patients are necessary to sub-stantiate our findings in this study.

摘要

目的与目标

确定在国家结核病控制规划(RNTCP)下接受治疗的新涂片阳性病例(1类)在第1、2和3个月每月的痰菌转阴率。

材料与方法

该研究于2005年7月至2006年6月在高哈蒂医学院和医院的直接观察短程治疗(DOTS)中心进行。该研究为前瞻性研究,包括100例新涂片阳性的肺结核病例(1类),不分年龄和性别。

结果与观察

100例患者的年龄和性别分布显示,大多数患者(74%)属于第二、第三和第四个十年,75%为男性,25%为女性,男女比例为3:1。100例涂片阳性患者的胸部X光检查显示,只有60例(60%)患者有肺部结核的X光证据。在本研究中,第1个月末痰菌转阴(即从涂片阳性转为涂片阴性)率为71%,第2个月末为84%,第3个月末为92%。

结论

总之,在高哈蒂医学院和医院的DOTS中心,100例痰涂片阳性肺结核患者在直接观察短程治疗(DOTS)化疗下的总体痰菌转阴率为92%。100例患者中有肺部结核的X光证据的比例为60%。第1个月末痰菌转阴率为71%,第2个月末为84%,第3个月末为92%。在本研究中,传染性从基线水平下降,对于3+、2+和1+痰菌阳性的痰菌转阴具有显著的P值。在资源匮乏的国家,直接观察治疗是提高结核病治疗方案依从性的有效干预措施。最初涂片高阳性病例的转阴率有显著下降。需要对更多患者进行更多前瞻性研究来证实本研究中的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9599/2822329/ada343e703cc/LI-25-118-g001.jpg

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