Tuberculosis 'retreatment others': profile and treatment outcomes in the state of Andhra Pradesh, India

Abstract

Setting: The Government of India's Revised National Tuberculosis Control Programme (RNTCP), Andhra Pradesh, South India.

Objectives: To study the basic characteristics and treatment outcomes of tuberculosis (TB) patients classified as 'retreatment others' and compare their treatment outcomes with smear-positive retreatment TB cases (relapse, failure, and treatment after default [TAD]).

Design: Retrospective record and report review of a patient cohort (n = 1237) registered as 'retreatment others' under the RNTCP from July to September 2008.

Results: Of 1009 patient records of 'retreatment others' reviewed, 674 (67%) were males, 892 (88%) were aged 15-64 years, 847 (84%) were pulmonary sputum smear-negative, 843 (84%) had unknown human immunodeficiency virus (HIV) status and 55 (5.5%) were HIV-positive. All patients were treated with the RNTCP intermittent (thrice weekly) retreatment regimen. Eighty per cent were successfully treated (cured plus treatment completed). Successful outcomes were higher in females (84%), in patients with extra-pulmonary TB (87%) and in HIV-negative patients (87%). The treatment outcomes were significantly better for 'retreatment others' (P < 0.05) than among the sputum smear-positive retreatment cases (78% for relapses, 59% for failures and 73% for TAD).

Conclusions: 'Retreatment others' were predominantly sputum smear-negative TB, with significantly better treatment outcomes than among smear-positive retreatment patients. Future studies may assess the accuracy of the diagnoses and factors contributing to the occurrence of 'retreatment others'.