Evaluation of the Application of DOTS Strategy in Gharbia Governorate
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- Category: Vol. 77, September 2009
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Evaluation of the Application of DOTS Strategy in Gharbia Governorate,EL SAYED SALEM, HODA BAHR, AYMAN SALEM, IBRAHEIM KHALIL, MOSTAFA EL ASEEL and AMAL A. WAFI
Abstract
Background: Egypt has succeeded in implementing the directly observed treatment, short course (DOTS) strategy nationwide. This strategy involves the direct observation of tuberculous patients during drug intake to ensure that the full treatment course is followed. It has been shown world-wide that patients treated without direct observation have a sub-stantially higher risk of adverse outcome than those treated under direct observation.
Objective: Estimate the risk of Mycobacterium Tubercu-losis disease in a trial to reduce its prevalence and evaluating DOTS strategy implementation in Gharbia Governorate to prevent the spread of tuberculosis in the community by early detection of patients with infectious tuberculosis and providing them with effective treatment to ensure a rapid and lasting cure. Diminished development of treatment failure and resistant cases would thus follow as an achievement.
Subjects and Methods: This study included 276 tuberculous patients who attented in the last two year 2006, 2007 in Mehalla El Kobra & Tanta chest centers. They were categorized according to their locality and study year. Their age, sex, site of tuberculosis, the regimen of drug used, were recorded. The treatment outcome of the patient and notification of number of cured, completed treatment, relapsed, treatment failure, transferred and died patients were also thus known.
Results: The 276 tuberculous patient, included 101 patients belonging to Mehalla (41 patients in 2006 & 60 patients in 2007) and 175 patients belonging to Tanta (88 patients in 2006 & 87 patients in 2007). The pulmonary form of the disease represented 77.23% in Mehalla and 76% in Tanta. The remaining were extrapulmonary. In relation to gender there were male predominance 64.36% in Mehalla & 69.71 in Tanta. The difference was statistically insignificant. The percent of treatment success in the form of cured and completed treatment patients were 88.12 in Mehalla & 77.14 in Tanta. The percent of treatment failure were 1.98 in Mehalla & 4.57 in Tanta. The percent of died patient were in 2.97 Mehalla & 5.72 in Tanta. The difference were statistically significant (p<0.05).
Conclusion: According to the international standard of Annual Risk of Infection (ARI), early detection of tuberculosis
cases needs to be improved, so that treatment would be initiated early enough to minimize pre-treatment transmission of infection in the community. The need for interventions aiming at, earlier identification of sources of infection and reducing tuberculosis transmission in the studied communities and in other similar communities, is urgent. However the outcome of successful manangement of the detected cases in the study fulfills the desired international standard in Mehalla and is promising in Tanta, which would satisfy the desired effect of avoiding resistence of the bacillus with its economic, medical and social burden.