Assistant Professor,^1,2 Professor & Head³

¹Department of Community Medicine, Dr D Y Patil Medical College, Pimpri, Pune, Maharashtra, India

²Department of Community Medicine, Dr D Y Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India

³Department of Community Medicine, Grant Medical College, Byculla, Mumbai, Maharashtra, India

Background

Tremendous progress has been made in combating TB over the past ten years. But, dramatic changes in TB epidemiology are challenging TB control activities.

Material Methods

An observational study at DOTS centers in E ward of Mumbai Municipal Corporation was carried out during 1^st January 2004 to 30^th June 2004. A Pre-tested structured interview schedules were fulfilled by interviewing new smear positive pulmonary tuberculosis patients registered during study period. Data regarding sputum smear examination report at the beginning & at the end of intensive phase were collected from respective DOTS centre.

Results

156 patients were interviewed with 67.3% males & 32.7% females. 24.2% were illiterate, 43.3% were unemployed, 52% belonged to socio-economic class IV & V, 53.8% were migrants.52.6% had history of known TB contact. High positive sputum smear was associated with history of known TB contact in family (p= 0.03, OR= 1.773, 95%CI= 1.102- 3.094). Patients with high sputum smear positivity were more likely to show sputum smear non-conversion at the end of intensive phase (OR= 2.347, 95% CI= 0.953- 5.782)..

Conclusion

Contacts in family play important role in causation of severe TB disease & consequently sputum non-conversion which is a risk factor for MDR-TB. Physicians or facilities can take decision about investigations like sputum culture and sensitivity at the earliest for such patients.