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Is direct observation therapy an effective treatment option for TB?

DOCTOR OF THE MONTH - Oct 2016
Oct 2016
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Answered by

General & Family Physician
Practicing since : 1988
Answered : 3688 Questions
Question
hi doctor, i hadnodes in my left side of neck which used to swell and back sometimes. these nodes were since i was in class 6th. in 2009 when i was in MBA, i got FNAC done which was negative. in July 2014, i was suspected of TB inspite of all tests negative just on the basis of positive biopsy of neck node. my x-ray showed calcified lesion in my lungs. my doctor told me that i used to have TB earlier which caused calcified lesions. but my body fought with it and somehow infection remained in the nodes which used to swell sometimes. there were no nodes in my stomach. i started category I TB medication in July 2014 and completed the same in Feb 2015. in August i started bleeding just after my month ended. In TVS USG there was some infection around my left ovary (sticky bowels) which got cleared in next USG. but nafter Feb' 2015, i was not able to conceive so i got HSG done in which my right tube was not visible and left was partially open. on USG, radiologist diagnosed a large cyst 12*7 cm around my right ovary but outside it. its not an ovarian cyst. after FNAC no cancer was diagnosed in it. only fluid is there inside it no solid mass. now doctor has advised me for 2nd category TB medication from DOT centre. but some doctors say that DOT centre is not effective. take private treatment. earlier i took private treatment only but could not be cured. kindly advise me what to do? private or DOT centre treatment?
Posted Tue, 25 Aug 2015 in Infections
 
 
Answered by Dr. Mohammed Taher Ali 2 hours later
Brief Answer:
DOT is most effective treatment.

Detailed Answer:
Dear XXXXXXX Ma'am,
Hi & Welcome to HCM.

I appreciate your concern for the efficacy of two treatment options for TB.
I have gone through your query diligently.

I would like to know the following details:

1. As advised by your treating doctor, can you please elaborate the meaning of 2nd category drugs or is it Second line of anti TB medications which are given to multi drug resistant patients?

2. What was the diagnosis made on abdominal ultrasound or FNAC done?
Was it just simple ovarian cyst or TB involving fallopian tubes?

Direct Observation Therapy (DOTS) is the most effective treatment options for TB. In this treatment a health care worker or other designated individual watches the patient swallow every dose of the prescribed drugs to enhance a better compliance (adherence to treatment) and thus efficacy.

It has a cure rates > 95%, prevents the bacterial drug resistance and hence the future relapse. Thus as compared to private treatment it is the most cost-effective of treatment for TB.

Hope to have answered your query.


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