Researchers said, “Although drug resistance presents a major challenge to TB control, effective treatment with DOTS-Plus can result in cure.”
In the
In order to curb the spread of worldwide MDR-TB infection, the World Health Organization (WHO) introduced the DOTS-Plus program in late 1990s. Eventhough a Satellite DOTS Plus Clinic was established in LCP as early as 2004, long term effects of the disease and the treatment to Filipino patients are still poorly understood. The researchers lamented, “Little is known about the long term follow-up of patients treated for MDR-TB, including rates of relapse, the factors associated with the failure and success of the treatment and chronic disability among cured persons.”
In the study entitled, A Two-Year Post –Treatment Follow-up of Multi-Drug Resistant Tuberculosis Cases Completing a Programmatic MDR-TB Managemenmt (DOTS-Plus) at the Lung Center of the Philippines: A Preliminary Report, 37 MDR-TB patients from the Lung Center who were cured after completing the two-year treatment under the DOTS-Plus program underwent follow up check-ups and assessment. In a span of two years, physical examinations were conducted every three months while sputum samples as well as chest X-ray were taken every six. Recurrence of the disease, deaths and economic impact of the diseases were recorded.
Results of the study showed that 61% of the patients had favourable outcome two years after the DOTS-Plus program and did experience recurrence of the infection. Four patients died during the course of the study – two due to massive hemoptysis, one because of heart failure and one died because of sepsis (systemic infection). In terms of economic impact of the disease, researchers reported that many of the patients were not able to resume their work or education.
Although some of the participants died, researchers argued that the rate of deaths in their study is far smaller than previously seen in foreign studies. Thus, overall, the researchers concluded that DOTS-Plus program is an effective way to cure the disease. They said, “Unlike previous reports of high death rates associated with MDR-TB, most of our patients met the definition of cure.”
To further strengthen the effectiveness of the DOTS-Plus program, the researchers recommended a more robust national program implementation of the program. The researchers insisted, “The program requires a sustainable and functioning national TB programme, drug availability at a reasonable cost, wide Directly Observed Treatment provision and infrastructure for monitoring and delivery of treatment.”