The aim of the study wasto assess directly observed therapy that applied to diagnosed cases of tuberculosis in the period from January 2002 to December 2006 in Banha chest hospital as a tool for treatment and control of tuberculosis in the community.
This study included 719 patients, 531 pulmonary and 188 extra pulmonary tuberculous cases.
For the subjects included in the study, the results of the following investigations were recorded and reviewed.
(A) Investigations for recorded pulmonary cases were reviewed as follows:
-Tuberculin skin test.
-Plain chest x ray (posterior-anterior and lateral views).
-Sputum for acid fast bacilli (3 successive morning samples were examined by direct microscopic smear stained with Ziehl Nelseen stain to detect tubercle bacilli).
(B) Investigations for recorded extra pulmonary cases were reviewed as follows* according to the site affected e.g.
-Lymph node biopsy in tuberculous lymphadenopathy.
-CSF examination by direct microscopic smear. Also they were subjected to: *Tuberculin skin test.
*Plain chest x ray (posterior-anterior and lateral views).
-Follow up of recorded smear positive pulmonary cases was done by sputum examination for acid fast bacilli by direct smear microscopy at 2 months, 5 months of treatment and at the end of treatment.
-Follow up of recorded smear negative pulmonary cases was done by sputum examination for acid fast bacilli by direct smear microscopy only at the end of 2nd month of treatment.
-There was no follow up for recorded extra pulmonary cases.
The data obtained were tabulated and statistically analyzed and the following results were obtained:
-There was an annual reduction in tuberculous cases from (30.2%) in 2002 to (13.5%) in 2006.
-The age group from 15 to < 30y represented the highest percentage of affected cases (35.3%).
-Male cases (54.1%) were higher than female cases (45.9%).
-Rural cases (76.2%) were higher than urban cases (23.8%).
-Pulmonary cases (73.9%) were higher than extra pulmonary cases (26.1%).
-There was significant reduction of pulmonary cases from 76.9% in 2002 to 65.9% in 2006 and there was significant increase in extra pulmonary cases from 23.1% in 2002 to 34.1% in 2006.
-Smear positive pulmonary cases (68%) were higher than smear negative pulmonary cases (32%).
-Lymph node tuberculous cases were the highest among extra pulmonary cases (31.9%).
-New cases (92.2%) represented the highest percentage of all cases attended for treatment.
-Sputum conversion was 87.5%, 89.5% and 92.8% at two months, five months of treatment and at the end of treatment respectively.
-Outcome of cases was obtained as follows:
*Cases that successfully treated were 89.4% (46.6% cured cases and 42.8% cases that completed treatment).
*Cases with failed treatment were 1.7%, Died cases were 3.3%, defaulters were 3.1% and transferred out cases were 2.5%.
-Cure rate was 92.8% and successful rate was 89.4% (higher than WHO target ''85 %'').
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