Effectiveness of the shorter MDR regimen in the management of tuberculosis: Shortfall in the outcome of disease a multidimensional approach and evaluation for a better alternative

Abstract

Background: Shorter multidrug-resistant (MDR) regimen has proved to be very effective in some of the developing nations such as Bangladesh and several African countries. Various shortcomings in the execution of long-term MDR regimen have prompted for adapting the shorter regimen in India. The study explored the experience of the programmatic management of tuberculosis by a shorter regimen in West Bengal, India. Materials and Methods: Retrospective analysis of the data included the outcome analysis of the cured, lost to followup, treatment completed, treatment failure, treatment regimen changed and died. These attributes were analyzed. Results: Of the total 203 cases, cure rate accounted for 44.3%. Lost to follow-up was found to be 13.7%, in which alternative dispute resolution accounted for the major cause. A substantial amount of INH resistance is seen among the follow-up culture positive cases speculating the role of ethionamide in the regimen.

Keywords

• adverse drug reaction
• line probe assay
• lost to follow-up
• multidrug-resistant shorter regimen