BACKGROUND: Although there are many studies on the effects of TB DOTS on the treatment outcomes of adults, there are limited studies in the pediatric population.

OBJECTIVE: To compare the treatment outcomes of pediatric PTB patients who were treated in the outpatient department (OPD) and the TB DOTS Center from January 2007 - December 2011.

METHODOLOGY: A retrospective cohort study was conducted at the De La Salle University Hospital in Dasmarinas, Cavite. Charts of pediatric pulmonary tuberculosis (PTB) patients at the OPD and TB DOTS Center from January 2007 - December 2011 were reviewed. Demographic data as well as outcomes were compared.

RESULTS: There were more patients treated for PTB at the OPD than in the DOTS, with age range between 1 -3 years old. Sixty-three percent of patients at the DOTS were initially seen by private practitioners. After two months of treatment, 98.2% of patients in DOTS and 84.1% in the OPD were still compliant. The difference in percentage of patients with weight gain, relief of fever, and improved general well-being after two months between DOTS and OPD were statistically insignificant. However, the percentage of patients with relief from cough after two months of treatment was significantly higher in DOTS versus the OPD. The treatment success at the DOTS is significantly higher than in the OPD (95.4% versus 54.2%), with an approximately 1.8x times likelihood of successful treatment.

CONCLUSION: Patients at the DOTS who had cough were more likely to improve than in the OPD. The percentage of patients who defaulted after two months of treatment increased in the OPD. At the end of six months, the TB DOTS had better percentage of successful treatment.

Human ; Male ; Female ; Child Preschool ; Infant ; Tuberculosis-diagnosis, therapy, therapeutics ; Tuberculosis, Pulmonary

INTRODUCTION: Tuberculosis has been a major problem in the Philippines for the past several decades ranking as the 6th (previously 5th) leading cause of mortality and morbidity based on the recent local data. For successful implementation of the Revised National Tuberculosis Control Program, treatment outcomes and factors which influence them need to be assessed on a regular basis. This study was done to find out the sputum conversion failure rate, socio-demographic factors and clinical profiles and comorbidities of new smear positive cases and retreatment cases of pulmonary tuberculosis seen and admitted at the Tuberculosis Center (TBC) of San Lazaro Hospital from January to June 2011.

METHODOLOGY: This is a records-based prospective analytical study design. Information pertaining to new smear-positive cases (or category I) and retreatment cases (or category II) were recorded using case report form.

RESULTS: Of the 131 TB patients, 63.3% were new smear-positive cases or on category I treatment. The sputum conversion failure rates among new case and retreatment PTB patients were 2.41% and 14.58%, respectively. Using chi-square test for independence to determine the association, the sputum conversion failure rates are dependent with the type of TB patient (i.e., new smear-positive case or retreatment case) (X²= 7.004, df= 1, P= 0.008). All clinical and socio-demographic factors were entered in the model for binary logistic regression analysis. Only hemoptysis (P= 0.024) and type of TB patient (P= 0.033) are statistically significantly associated with sputum conversion failure. The odds of having a sputum conversion failure after intensive phase of treatment are 9.8 times (95% Cl: 10349-71.779) among TB patients with hemoptysis upon admission as compared to those TB patients without hemoptysis, and 8.1 times (95%Cl: 1.179-55.423) among TB patients who were admitted for retreatment (due to relapse, return after default, or treatment failure) as compared to those TB patients who were admitted as new smear-positive cases.

CONCLUSION: Sputum conversion rates were generally satisfactory in this study. However, the sputum conversion failure rates among new smear-positive cases and retreatment PTB patients were 2.41% and 14.58%, respectively. Among the rid factors, hemoptysis (OR= 9.8, 95%CL: 1.349-71.779, P= 0.024) and retreatment PTB patients (OR= 8.1, 95%Cl: 1.179-55.423, P=0.033) are statistically significantly associated with sputum conversion failure.

Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; Tuberculosis, Pulmonary-Therapeutics, therapy ; Sputum