The study was carried out to evaluate performance of DOTS programme (directly observed short course treatment) in Najaf governorate, that was established by the WHO. Two cohorts of patients attending Najaf TB center were followed retrospectively. The 1st cohort included 180 patients registered from 1/4/2000 – 31/3/2001, while the second cohort included 232 patients registered from 1/4/2001 – 31/3/2002. The collected data were analysed for case detection, treatment outcomes, retreatment outcomes, treatment success and retreatment success.
The following rates are extracted from the 1st and 2nd cohorts:
• Case detection rate: 34.7% and 47.9% respectively.
• Treatment outcome for new patients (cured=68.8%, completed treatment=8.2%, defaulter=18%, treatment failure=3.3%, died=0.0% and transfer out=1.6%) and (cured=66.3%, completed treatment=9.9%, defaulter=10.9%, treatment failure=3%, died=5% and transfer out=5%) respectively.
• Treatment outcome for retreatment patients (cured=50%, completed treatment=0.0%, defaulter=50%, treatment failure=0.0%, died=0.0% and transferout=0.0%) and (cured=76.2%, completed treatment=4.8%, defaulter=14.3%, treatment failure=0.0%, died=4.8% and transferout=0.0%) respectively.
• Treatment success rate: 77% and 76.2% respectively.
• Retreatment success rate: 70% and 81% respectively.
These findings are lower than the WHO targets with regard to case detection rate, treatment success rate and retreatment success rate (70%, 85% and 85% respectively). Application of (Z-test) revealed significant statistical differences which indicate a clear defect in programme performance. |