15.5 Treatment outcomes
As you know, treatment is completed when the patient has taken the correct number of doses of the continuation-phase drugs. If the patient has missed some doses along the way, the duration of the treatment extends until all the doses in the patient’s drug box are taken, which will be some days or weeks longer. Some patients do not complete treatment, either because they die during treatment or more likely they stop coming for treatment and cannot be located. When each patient completes treatment or stops coming for treatment, record that patient’s outcome on the TB treatment registration form.
Possible treatment outcomes are defined as follows:
Cured
An intensively smear-positive patient who is sputum smear-negative at completion, or one month prior to the completion of treatment, and on at least one previous occasion (usually at the end of the second or fifth month).
Treatment completed
A patient who completed treatment but for whom smear results are not available at month seven or one month prior to the completion of treatment.
Treatment failure
A patient who remains or becomes again smear-positive at the end of month five or later during treatment. The same outcome would apply to a patient who was sputum smear-negative at the beginning of treatment and smear-positive at the end of the intensive phase.
Died
A patient who dies for any reason during the course of treatment.
Defaulter
A patient who has been on treatment for at least four weeks and whose treatment was interrupted for eight or more consecutive weeks.
Transfer out
A patient who started treatment and was transferred to another reporting unit and for whom the treatment outcome is not known at the time of evaluation of treatment results.
Treatment success
The total number of patients who are declared ‘cured’ and those who have ‘completed’ treatment.
At the end of treatment of tuberculosis with anti-TB drugs the outcome for the treated patient should be documented and reported to the District Health Office. You will no doubt be very pleased with ‘cures’ and you should achieve some satisfaction that as a HEP you have contributed to making such a difference to a person. In fact, for all the TB patients that come into your care, you are in a position to make an important contribution to improving their well-being and increasing the chances of success.
15.4.3 Tracing patients who interrupt treatment