DOTS for TB relapse in India: A systematic review.
DOTS for TB relapse in India: A systematic review.
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DOI：
10.4103/0970-2113.95320
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发表时间：
2012-04
期刊：
影响因子：
--
通讯作者：
Azhar GS
中科院分区：
文献类型：
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作者：
Azhar GS
在印度，根据经修订的国家结核病控制方案，痰检阳性再治疗病例的百分比很高。再次治疗的原因包括成功完成治疗后疾病复发、治疗失败和不接受治疗。RNTCP在成功完成治疗后的任何一段时间内都不会对患者进行随访，以确定他们是否复发。鉴于国家结核病控制方案下每个病人的治疗费用很高，而且这些病人有可能传播疾病，因此，深入了解其背后的原因，对于该方案的成功和该国的疾病控制至关重要。对文献进行系统回顾，并根据DOTS指南确定关于标准短程化疗成功治疗后结核复发的证据。检索了Medline、科克伦数据库、Embase等数据库和文献参考列表。从这些搜索中获得了255篇论文。在应用纳入、排除和质量评估标准后，7项研究最终被纳入综述。印度的R0失效率很高（近10%），高于国际研究。大多数复发病例在完成治疗后不久（前六个月）出现。复发的危险因素包括药物不规则性，初始耐药，吸烟和酗酒，性别和体重在印度不是危险因素。复发病例接受治疗的结果是积极的，但效果不如新病例。有充分的论据和粗略的证据表明，DOTS第2类治疗可能不足以复治患者。
In India, under the Revised National Tuberculosis Control Program (RNTCP), the percentage of smear-positive re-treatment cases is high. The causes of re-treatment include relapse of the disease after successful completion of treatment, treatment failure, and default in treatment. RNTCP does not follow up the patients for any period of time after successful completion of treatment to determine whether they relapse. Given the high cost of treatment for each patient under RNTCP and the potential for spread of disease from these patients, it is crucial for the success of the program and control of the disease in the country to find out more about the reasons behind this. T0 o conduct a systematic review of literature and determine evidence regarding recurrence of TB after its successful treatment with standard short course chemotherapy under DOTS guidelines. T0 en databases were searched including Medline, Cochrane database, Embase and others and reference lists of articles. 255 papers resulted from these searches. Seven studies were finally included in the review after applying the inclusion, exclusion and quality assessment criteria. R0 elapse rate is high (almost 10%) in India which is higher than international studies. Majority of relapse cases present soon after completion of treatment (first six months). Risk factors for relapse included drug irregularity, initial drug resistance, smoking and alcoholism Sex and weight were not risk factors in India. The outcome of relapse cases put on treatment is positive but less effective than new cases. There are sound arguments and sketchy evidence that DOTS Category 2 treatment may not be adequate for retreatment patients.