title: Risk factors for new pulmonary tuberculosis patients failing treatment under the Revised National Tuberculosis Control Programme, India.
abstract: METHODS
  Tertiary level tuberculosis (TB) institute in Delhi, India.
  
  
  OBJECTIVE
  To study the risk factors for new pulmonary TB (PTB) patients failing treatment.
  
  
  METHODS
  Prospective case-control study. The profile of new PTB patients failing treatment (i.e., sputum smear-positive at 5 months of treatment) and responders under the Revised National Tuberculosis Control Programme (RNTCP) were compared and risk factors associated with treatment failure were analysed.
  
  
  RESULTS
  A total of 42 treatment failure cases and 76 controls were enrolled in the study. The presence of cavity on chest X-ray (CXR), sputum acid-fast bacilli (AFB) smear positivity at 2 months of treatment and the number of interruptions in treatment were independently associated with failures. Among failure patients at 5 months, 17 (40.5%) had negative sputum culture for Mycobacterium tuberculosis, and only six (14.3%) had multidrug-resistant TB (MDR-TB). When put on retreatment, patients with smear-positive, culture-negative sputum had cure rates of 88.2% compared to 28.6% among culture-positive patients.
  
  
  CONCLUSIONS
  The presence of cavity on CXR, sputum smear positivity at 2 months of treatment and the number of interruptions of treatment are risk factors for failure. Among failures based on smear examination, the prevalence of MDR-TB is low and many patients have negative cultures for M. tuberculosis. Smear positivity at the end of treatment may not be a reliable indicator of treatment failure.
authors.affiliation: Department of Tuberculosis and Chest Diseases, Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases, New Delhi, India. drrupaksingla@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Singla
authors.forename: D
authors.initials: D
authors.lastname: Srinath
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: P
authors.initials: P
authors.lastname: Visalakshi
authors.forename: U K
authors.initials: UK
authors.lastname: Khalid
authors.forename: N
authors.initials: N
authors.lastname: Singla
authors.forename: U A
authors.initials: UA
authors.lastname: Gupta
authors.forename: S K
authors.initials: SK
authors.lastname: Bharty
authors.forename: D
authors.initials: D
authors.lastname: Behera