Tuberculous lymphadenopathy: a multicentre operational study of 6-month thrice weekly directly observed treatment

• Published in: The international journal of tuberculosis and lung disease Vol. 17; no. 2; pp. 234 - 239
• Main Authors: Jindal, S. K., Aggarwal, A. N., Gupta, D., Ahmed, Z., Gupta, K. B., Janmeja, A. K., Kashyap, S., Singh, M., Mohan, A., Whig, J.
• Format: Journal Article
• Language: English
• Published: Paris, France International Union Against Tuberculosis and Lung Disease 01.02.2013; International Union against Tuberculosis and Lung Disease
• Subjects: Adolescent; Adult; Antitubercular Agents - administration & dosage; Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Child; Child, Preschool; Directly Observed Therapy - methods; Directly Observed Treatment; Drug Administration Schedule; Female; General aspects; Human bacterial diseases; Humans; Infectious diseases; Intermittent Therapy; Isoniazid - administration & dosage; Isoniazid - therapeutic use; Lymphadenopathy; Male; Medical sciences; Middle Aged; Mycobacterium; Planification. Prevention (methods). Intervention. Evaluation; Pneumology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Pyrazinamide - therapeutic use; Revised National Tuberculosis Control Programme; Rifampin - administration & dosage; Rifampin - therapeutic use; Treatment Outcome; Tuberculosis; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Lymph Node - drug therapy; Young Adult; Sanitary program; directly observed treatment; Mycobacterial infection; lymphadenopathy; Infection; intermittent therapy; Treatment; Tuberculosis; Revised National Tuberculosis Control Programme; Intermittent; Adenopathy; Bacteriosis; Pneumology
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.12.0333

SETTING: Eight operational locations for the Revised National Tuberculosis Control Programme in six Indian states.OBJECTIVE: To assess the 6-month efficacy of an intermittent thrice-weekly directly observed treatment (DOT) regimen for tuberculous peripheral adenopathy and the need for prolongation of treatment to 9 months for non-resolution of lymphadenopathy.DESIGN: Patients aged >5 years with tuberculous lymphadenopathy were included in the study. Patients were evaluated for resolution at repeat visits following treatment. Those with poor resolution at 6 months were randomised to extended treatment up to 9 months or observation without additional treatment.RESULTS: Resolution of lymphadenopathy was observed at the end of 6 months in 517/551 (93.8%) patients. There was a significant difference in response among patients with and those without the presence of systemic symptoms. There was no association between treatment response and number, size, site, consistency and matting of lymphadenopathy. No differences in response were seen in the remaining 34 patients with or without extended treatment.CONCLUSION: The operational efficacy of 6-month thrice-weekly DOT for peripheral tubercular lymphadenopathy was satisfactory. There was no evidence of additional benefits of prolonging treatment to 9 months.