Clinical Audit On Diagnosis And Therapeutic Outcomes Of Tuberculosis Patients In Rntcp/Dot Centers Of Primary Health Care Settings

Abstract

This clinical audit investigates the diagnosis and therapeutic outcomes of tuberculosis (TB) patients at RNTCP/DOT centers within primary healthcare settings; the study evaluates the adherence to RNTCP guidelines and the resulting therapeutic outcomes. Utilizing a descriptive, cross-sectional design, the audit spans from June 2022 to March 2023, covering four PHCs in North Bangalore. The study includes a sample size of 999 patients, focusing on adults diagnosed with TB and tracking their treatment and recovery. Key findings include a detailed demographic breakdown, with males constituting 52.35% and females 47.67% of the sample. The audit also identifies common co morbidities, such as TB combined with diabetes mellitus (27.44%) and hypertension (20.27%). The audit highlights the efficiency of diagnostic processes, with a significant portion of patients undergoing necessary examinations and tests, including chest X-rays and sputum analysis. Treatment adherence and outcomes were assessed, revealing a high cure rate of 89.48%, but also noting challenges such as a 6.206% loss to follow-up and a 3.903% treatment failure rate. Gaps evolved in recording of body weight (81%), the follow up first 40%,second 15%,third 5% ,physical examination 97% and chest x- ray89% and documentation of findings with 95% where the health care professional didn’t meet up their target level of performance, and the same followed up during the course of therapy for 9 months of period with minor deviations from target level of performance The study underscores the importance of strict adherence to standardized treatment protocols like DOTS and the potential benefits of adjunctive therapies, such as corticosteroids for tubercular pleural effusion. The findings suggest areas for improvement in both diagnostic and treatment phases, aiming to enhance the quality of care and overall management of TB within community healthcare frameworks. This comprehensive audit provides valuable insights for optimizing TB management and improving patient outcomes in primary health care settings.