TB contacts in family and high positive smear: Is there a need of sputum culture at the earliest?
Keywords:
Anti tubercular treatment (ATT), DOTS, High Positive Smear (HPS), MDR-TB, RNTCP, TuberculosisAbstract
Aim- To assess the role of TB contacts at various places in severity of PTB.
Background- Tremendous progress has been made in combating TB over the past ten years. But, dramatic changes in TB epidemiology are challenging TB control activities.
Material Methods- An observational study at DOTS centers in E ward of Mumbai Municipal Corporation was carried out during 1st January 2004 to 30th June 2004. A Pre-tested structured interview schedules were fulfilled by interviewing new smear positive pulmonary tuberculosis patients registered during study period. Data regarding sputum smear examination report at the beginning & at the end of intensive phase were collected from respective DOTS centre.
Results- 156 patients were interviewed with 67.3% males & 32.7% females. 24.2% were illiterate, 43.3% were unemployed, 52% belonged to socio-economic class IV & V, 53.8% were migrants.52.6% had history of known TB contact. High positive sputum smear was associated with history of known TB contact in family (p= 0.03, OR= 1.773, 95%CI= 1.102- 3.094). Patients with high sputum smear positivity were more likely to show sputum smear non-conversion at the end of intensive phase (OR= 2.347, 95% CI= 0.953- 5.782)..
Conclusion- Contacts in family play important role in causation of severe TB disease & consequently sputum non-conversion which is a risk factor for MDR-TB. Physicians or facilities can take decision about investigations like sputum culture and sensitivity at the earliest for such patients.
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