اپيدميولوژي بيماران درمان مجدد سل ريوي

Epidemiological Assesment of Re-treatment in Pulmonary Tuberculosis Patients at Daneshvary Hospital in Tehran

WHO divides tuberculosis into four categories according to involvement and treatment history: new patients with positive sputum and extra pulmonary are in the first category, re-treatment patients in the second category, pulmonary tuberculosis with negative sputum smear in the third category and chronic tuberculosis patients with positive sputum in the fourth category. Researchers have indicated that epidemiological evaluation of re-treatment patients can be effective in the planning in treatment protocols and patientʹs satisfaction. This research was conducted to determine the epidemiological assessment of re-treatment in pulmonary tuberculosis patients at Daneshvary Hospital in Tehran. This study was a cross- sectional study in nature. In this study, 292 medical records were evaluated, consisting of 261 cases with a new positive smear and 31 cases of re-treatment patients. All patients were registered during 1999. Out of the 292 positive sputum patients, 31 (11%) were re-treatment patients. About 35% were classified as relapse cases, 10% as defaulters and 55% as failures. The percentage of cured patients in defaulters was more and in failures less than other classes. The strongest risk factor associated with relapse was poor treatment and the strongest risk factor associated with default was disorganization and unavailability of health services and the strongest risk factor associated with failure was drug indication and drug resistance, more attention should be focused on the above matters by responsible agencies.