TREATMENT OUTCOME OF PULMONARY TUBERCULOSIS UNDER OBSERVATIONAL THERAPY: AT DISTRICT SWAT, KPK, PAKISTAN

Background & Objective: The treatment of tuberculosis is cheap and highly effective, yet world wide thedisease remains a serious cause of illness and death. That's why WHO has called for the universal adaptationof DOTS (Directly observe treatment short course). The aim of this study was to analyze the effectiveness ofDOTS in term of cure and treatment completion rates among pulmonary tuberculoses patients at DistrictSwat, after the implication of DOTS. Methods: 167 male and female pulmonary tuberculosis patients age more than 15 years were enrolled forthe third quarter of 2002 (July to September) and were assessed on the basis of history chest X-ray, sputumsmear microscopy and culture. Results: Out of 167 patients, 108(65%) were sputum smear positive by direct microscopy and 59(35%)were sputum smear negative patients confirmed on clinical grounds. The treatment outcome was calculated12-15 months later. The outcome was 53% cured, 34% completed, 1% died, 9% defaulted, 0% failed and 3%transferred out. Notification rate was 152/100,000 population and case detection rate was 65% in pulmonarytuberculosis patients. Cure rates among the groups of supporters as by family members were 78% and 68%by Lady Health Workers. Conclusion: To achieve the target of 70% case detection and 85% treatment success, the health educationpromotion, fully involvement of lady health workers in the program and training in DOTS of care providerswith flexible DOTS (individualized as necessary) component of observation with in the socio-cultural andlocal circumstances are the needs of the future program. Keywords: DOTS, Swat, Kyber Pakhtonkhwa, Pakistan