Treatment Outcomes of Inmates with Pulmonary Tuberculosis in Baquba Penitentiary: A Follow-Up Study

Abstract

Objective: To assess the treatment outcomes of inmates with pulmonary tuberculosis (PTB) in Baquba penitentiary.Patients & methods: The treatment outcomes of 23 prisoners with PTB in Baquba penitentiary were followed-up for the period from 1stApril 2000 to 30th September 2001. The mean age of patients was 23.5 years. The diagnosis of PTB was based on standard clinical, radiological and bacteriological criteria. The treatment regimens followed the World Health Organization (WHO) guidelines, the directly observed therapy short course (DOTS). Follow-up investigations based on chest X-ray and sputum examination for acid fast bacilli (AFB). For isolation of Mycobacterium tuberculosis (MTB) culture was done on Lowenstein-Jensen medium. The susceptibility to (40 μg/μl) rifampicin and (0.2 μg/μl) isoniazide was tested by proportional method.Results: The results showed that 17(80.9%) of patients were newly diagnosed (NDPTB), and 4(19.1%) were relapsed cases. Of the NDPTB and relapsed cases, 14(82.3%) and 3(75%) were sputum smears positive respectively. The cure rate of sputum smears positive NDPTB after completion of the first course of (2HRZS/4HR) was 92.3%. Additionally, all sputum smear negative NDPTB were cured after completion of treatment with 2HRZS/4HR or 2HRZE/4 HR. Concerning the relapsed cases, 3 (75%) were cured after treatment with 2HRZES/1HRZE/5HRE. Whereas, the treatment was failed in the fourth patient, who underwent a second course of treatment. Culture and sensitivity test showed that the MTB isolated from the sputum of that patient was resistant to rifampicin and isoniazide.Conclusion: The implementation of DOTS strategy has undoubtedly increases the cure rate of PTB regardless the sputum smear status. However, the emergence of multidrug resistant MTB in such settings may have unfavorable consequences.Keywords: penitentiary, tuberculosis, Treatment outcomes