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Objective: To assess the treatment outcome and follow-up status of newly diagnosed Tuberculosis (TB) patients registered in Directly Observed Treatment Short course (DOTS). Study Design: Descriptive case series study. Place and Duration: Department of Pathology TB Laboratory, Allama Iqbal Medical College (AIMC) during the period of 12th May 2016 to 25th March 2017. Methodology: Study was carried out among Patients referred to TB laboratory, from DOTS clinic Jinnah Hospital Lahore Pakistan for ZN smear microscopy. Sputum samples were collected at 2nd, 4th and 6th months and processed for Ziehl Nelson (ZN) smear microscopy and Löwenstein-Jensen (LJ) culture. All cases that were positive on LJ culture on follow up were also processed for GeneXpert Mycobacterium tuberculosis/Rifampicin (MTB/RIF) Assay. If any cases were diagnosed as multi drug resistant (MDR) they were referred to MDR clinic for further management. Outcome were evaluated in accordance with World Health Organization (WHO) recommendation and classified as: cured, treatment completed, defaulted, treatment failure, death or other. Results: Among 109 ZN smears positive patients 100% were also positive for MTB on LJ culture at the time of diagnosis. Male and females were 55.9%, 44.0% respectively, mean age was 38.40 + 18.55 years. Overall mortality rate was 6.4%, completely cured 76.1%, treatment failure and MDR 1.8%, defaulted 13.7%. ZN smear conversion rate was 96.1%, 97.8% and 97.6% at 2nd, 4th and 6th month respectively. Conclusion: The results of the present study concluded that DOTS is an effective therapy for treatment of TB patients. It not only keeps patients to cure completely by completing treatment but also identifies the MDR-TB cases which can be referred to MDR clinic immediately for purpose of treatment. [ABSTRACT FROM AUTHOR]

A public–private mix tuberculosis (TB) DOTS project was implemented to enhance coverage and collaboration between the public and private sectors, with an objective to increase case detection and to improve TB case management in a large urban area. General practitioners (GPs) were trained to provide DOTS services. Patients were diagnosed and treated as per national guidelines and outcomes were reported to national TB control program. Treatment and sputum microscopy were provided free of cost. A total of 94 GPs were trained. In all, 57.4% of trained GPs remained actively involved in the project. Overall treatment success rate of the patients enrolled with the project was 86.3% with 8.7% default patients. Experience suggests that a more stringent selection criteria need to be followed for inclusion of GPs in the program to improve the success of the program. A multifaceted context specific approach is needed while working with private health care providers. [ABSTRACT FROM PUBLISHER]

Tuberculosis (TB) is a respiratory infectious disease which shows seasonality. Seasonal variation in TB notifications has been reported in different regions, suggesting that various geographic and demographic factors are involved in seasonality. The study was designed to find out the temporal and seasonal pattern of TB incidence in Lahore, Pakistan from 2006 to 2013 in newly diagnosed pulmonary TB cases. SPSS version 21 software was used for correlation to determine the temporal relationship and time series analysis for seasonal variation. Temperature was found to be significantly associated with TB incidence at the 0.01 level with p=0.006 and r=0.477. Autocorrelation function and partial autocorrelation function showed a significant peak at lag 4 suggesting a seasonal component of the TB series. Seasonal adjusted factor showed peak seasonal variation in the second quarter (April-June). The expert modeler predicted the Holt-Winter's additive model as the best fit model for the time series, which exhibits a linear trend with constant (additive) seasonal variations, and the stationary R(2) value was found to be 0.693. The forecast shows a declining trend with seasonality. A significant temporal relation with a seasonal pattern and declining trend with variable amplitudes of fluctuation was observed in the incidence of TB., (Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.)