In RNTCP what is the schedule for sputum examination after beginning the chemotherapy, in category I patients -

Ans. is 'a' i.e., 2, 4 and 6 months o In category I, sputum examination is done at 2 months after the treatment, i.e. at the end of intensive phase of treatment. i) If test is negative, continuation phase is staed and sputum is tested again at 4 and 6 months. If test is positive, intensive phase is continued for one more month. o The number before the letters refers to the number of months of treatment. The subscript after the letters refers to the number of doses per week. H : Isoniazid (600 mg), R : Rifampicin (450 mg), Z : Pyrazinamide (1500 mg), E : Ethambutol (1200 mg), S : Streptomycin (750 mg). Patients who weight more than 60 kg receive additional Rifampicin 150 mg. Patients more than 50 years old receive streptomycin 500 mg. Patient in categories I and II, Who have a positive sputum smear at the end of the initial intensive phase, receive an additional month of intensive phase treatment. o Examples of seriously ill extra-pulmonary TB cases are meningitis, disseminated TB, tuberculous pericarditis, peritonitis, bilateral or extensive pleurisy, spinal TB with neurological complications and intestinal and genito-urinary TB. o In rare and exeptional cases, patients who are sputum smear-negative or who have extra-pulmonary disease can have relapse or failure. This diagnosis in all such cases should always be made by an MO and should be suppoed by culture or histological evidence of current, active tuberculosis. In these cases, the patient should be categorized as 'other' and given category II treatment. o Any patient treated with category I who has a positive smear at 5 months of treatment should be considered a Failure and staed on category II treatment, afresh. If category I sputum smear-ye case fails to improve or if patient develops pulmonary signs and positive smear at the end of intensive phase, it is considered treatment failure. Sta category II treatment and confirm failure by culture and perform DST.