Five year record based study of Paediatric tuberculosis (TB) from a directly observed treatment short-course (DOTS) centre of South Delhi

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Author: 
Saxena, A., Khokhar, A., Gupta, D. and Mate, C. K.
Subject Area: 
Health Sciences
Abstract: 

Background: TB continues to be a public health problem in India despite the government-run nationwide control programme. Till now the focus has been on adult TB, be it preventive or curative, with very little thrust on paediatric TB. Children are particularly vulnerable to severe disease and death following infection, and children with latent infections become reservoirs for future transmission following disease reactivation in adulthood, thus contributing to future epidemics. Research on understanding of paediatric TB is urgently needed. This paper attempts to study the epidemiology, prevention and treatment of paediatric Tuberculosis. Objective: To study the socio-demographic profile, pattern of TB, treatment completion rate and associated factors amongst paediatric TB patients from a DOTS centre of South Delhi Material and Methods: 5 year record based from 2011-2016 (June). DOTS centre located at a Public sector hospital of South Delhi. Data acquired from New Delhi Municipal Corporation (N.D.M.C) Chest Clinic, ShahidBhagatSingh Marg, New Delhi. Paediatric age group taken as 0-14 years as described in the Revised National Tuberculosis Control Program (RNTCP). Data entered and analysed in Microsoft Excel spreadsheets. Results: Out of the total number of patients enrolled in the same time period (5 years) 8.62 % of the patient load was of paediatric TB. Total paediatric patients in 5years were 153, out of which 42 (27.45 %) were males and 111 (72.55 %) were females. Out of the 153 cases, 143 were treated as Category I patients while only 10 were treated as Category II patients. Out of the 10 Cat II patients, 1 patient was due to failure of treatment by Cat I, 1 was due to relapse, and the rest were default/ other reasons. 51 (33.33 %) cases were of Pulmonary TB while 102 (66.67 %) cases were of Extra-pulmonary TB. Treatment completion rate was 98.69 % (151 cases) with 1 case defaulting on treatment (0.65 %) and 1 case being transferred out (0.65 %). Among the patients who completed the treatment (151), 149 patients were reported as treatment completed/cured (98.67 %), while 2 cases (1.32 %) ended up with Multi-drug Resistant (MDR) TB. For patients not reporting for treatment/collection of medicines on the scheduled date, phone calls were made to the patient-provided phone number for a response, failing which, a house visit was done by the health worker to ensure minimum number of defaulters. INH prophylaxis was given to children less than 6 years of age, who were close contacts of the patients. However, no data was available regarding the same. Conclusion: Treatment completion rates are high under RNTCP (98.69 %) but follow up action for defaulters and INH prophylaxis for less than 6 year old close contacts of patients with Cat 1 TB leaves a lot of scope for improvement.

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