Final Treatment Outcomes of DR-TB Cases

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Final Treatment Outcomes of DR-TB Cases

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Under the National TB Elimination Programme (NTEP), the treatment outcome definitions of Drug-susceptible TB (DS-TB) and Drug-resistant TB (DR-TB) have been aligned in recent times. However, the treatment outcome is declared at different time points for certain outcomes (e.g., cured/ treatment completed) since the duration of DR-TB treatment is longer when compared to DS-TB treatment.

Table: Final DR-TB Treatment Outcomes
TREATMENT OUTCOMES	DEFINITION	REMARKS
Treatment failed	A patient whose treatment regimen needs to be terminated or permanently changed to a new regimen option or treatment strategy.	Reasons for the change include: No clinical and/or bacteriological response (a bacteriological conversion with no reversion) Adverse Drug Reactions (ADRs) Evidence of additional drug resistance to medicines in the regimen
Cured	A pulmonary TB patient with bacteriologically confirmed TB at the beginning of treatment who completed the treatment as recommended by the national policy with evidence of bacteriological response and no evidence of treatment failed.	Bacteriological response - bacteriological conversion with no reversion.
Treatment completed	A patient who completed the treatment as recommended by the national policy whose outcome does not meet the definition for cured or treatment failed.	---
Died	A patient who died before starting or during the course of treatment.	Patient died of any reason.
Lost to follow-up	A patient who did not start the treatment or whose treatment was interrupted for 2 consecutive months or more.	---
Not evaluated	A patient for whom no treatment outcome was assigned.	This includes cases “transferred out” to another treatment unit and whose treatment outcome is unknown and excludes patients who lost to follow-up.

Points to Note

In case of a change in the regimen within the scope of the guidelines, from shorter to longer or vice-versa in the initial months before any definitive treatment outcome applies, the outcome of only the changed regimen needs to be reported. The patient needs to be moved out of the denominator of the previous regimen.
Patients who are still on treatment due to frequent short interruptions (less than 2 consecutive months) due to patient or provider requirements can be reported as not evaluated as an outcome is not assigned at the time of reporting, but the data can be cleaned and updated later when the outcome is available.

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