Background: The World Health Organization (WHO) declared tuberculosis (TB) a global public health emergency in 1993. It is the second leading cause of death from an infectious disease worldwide and leading cause of ill- health among millions of people. Treatment options of tuberculosis include intermittent therapy in DOTS and daily therapy. Aim of our study is to compare daily versus intermittent antituberculous treatment.

Methods: This observational prospective study was conducted at Indira Gandhi Medical College, Shimla. Detailed information was collected on predesigned proformas and results were compiled and evaluated on master chart.

Results: 460 children were diagnosed with various forms of tuberculosis, out of which 82 children fulfilling the inclusion criteria were enrolled in this study. These were divided into two groups (Group 1 and Group 2). The mean age at the time of enrollment was 10.34 years  42 (53.16%) were males and 37 (46.83%) females, with a sex ratio of M:F=1.1:1. sputum negativity in the daily therapy group showed statistical significance with a p value of < .05, an odds ratio of 0.17 with Confidence Intervals : 0.02 – 0.94.

Conclusion: Tuberculosis remains a major cause of mortality and morbidity in Pediatric population. Daily therapy may be a futuristic treatment option with better results.

Keywords: Tuberculosis Pediatric, Daily, Intermittent, Gastric aspirate.

1. Dias Hannah Monica, Falzon Dennis. Global tuberculosis Report 2012, World Health Organization, 2012 (WHO/HTM/ STB/2012.
2. Global tuberculosis control—epidemiology, strategy, financing. WHO Report 2014 http://www.who.int/tb/publications/global_report/2014/en/index.html. Accessed 31 May 2014.
3. Kochi A. The global tuberculosis situation and the new control strategy of the World Health Organization.Tubercle 1991; 72:1–6.
4. Raviglione M C, Snider D E, Kochi A. Global epidemiology of tuberculosis. JAMA 1995; 273:220–226.
5. Munoz Flor M, Starke Jeffery R 213.Nelson 19th edition ;Elisevier: 960 61
6. Chadha VK, Kumar P, Jagannatha PS, Vaidyanathan PS, Unnikrishnan KP. Average annual risk of tuberculous infection in India.Int J Tuberc Lung Dis 2005; 9(1):116-8.
7. RNTCP new pediatric guidelines 2012 National Guidelines on diagnosis and treatment of Pediatric Tuberculosis.
8. Kansoy S, Kurta N, Ak ít S, Aksoylar S, Yaprak I, Çalayan S. Superiority of intermittent-short course chemotherapy in childhood pulmonary tuberculosis. Turkish Journal of Medical Sciences1996; 26(1):41–3.
9. Sarin R, Sharma S, Khalid U.K, et al. The DOTS strategy for treatment of pediatric pulmonary tuberculosis in South Delhi, India. Int J Tuberc Lung Dis; 11(12): 74-80.
10. Naude Te Water, Donald PR, Hussey GD, Kibel MA, Louw A, Perkins DR, et al. Twice- weekly vs daily chemotherapy for childhood TB. Pediatr Infect Dis J 2000; 19:405-410.
11. Göçmen A, Özçelic U, Kiper M, et al. Short course intermittent chemotherapy in childhood tuberculosis. Infection 1993; 21: 324-327.
12. Al-Dossary FS, Ong LT, Correa AG, Starke JR. Treatment of childhood tuberculosis with a six month directly observed regimen of only two weeks of daily therapy. Pediatr Infect Dis J 2002; 21:91-97.
13. Salih M, Eltayeb I, Zaki A, et al. Intermittent chemotherapy compared to the daily regimen in Sudanese patients with pulmonary tuberculosis. Time Journal of Medical Sciences Report and Research; 1(3): 2013.
14. Prasad R, Rizavi D M, Kant S, et al. A comparison of unsupervised treatment along with intensive health education and directly observed treatment in pulmonary tuberculosis. Ind.J. Tub, 2001; 48,21.
15. Qayyum S, Ahmed, Ansari G. Comparing daily versus partially intermittent regimen of ATT in non HIV patients with new pulmonary tuberculosis in Dots programme: OJHA Institute of Chest Diseases, Karachi.
16. Mandal P, Mandal A,et al. comparing daily versus intermittent regimens of anti-tubercular chemotherapy. Journal of Clinical and Diagnostic Research,2012.
17. Anil K Kashyap, Jagdeep Whig, Dinesh Gupta, Smiley Joshi. Clinical outcome of patients of tuberculosis under directly observed treatment short course in a tertiary care centre in Ludhiana India; Chest: Nov 3,2009.
18. Kumar L, Dhand R, Singhi PD, Rao KL, Katarriya S. A randomized trial of fully intermittent and daily followed by intermittent short-course chemotherapy for childhood tuberculosis. Pediatr Infect ds J 1990; 9:802-806.
19. Ramachandran P, Kripasankar A S, Duraipandian M. Shortcourse chemotherapy for pulmonary tuberculosis in children. Indian Journal of Tuberculosis 1998; 45:83-7.
20. Indumati C K, Prasanna K, Dinakar C, et al. Intermittent short course therapy for pediatric tuberculosis. Indian Pediatrics; Vol 47, Jan: 2010.
21. Diga R, Dalisay C. Comparison of modified directly observed therapy versus conventional treatment for active pulmonary tuberculosis. Phil Journal of Chest Diseases; 12(1):1-6.
22. Mehrotra ML. Agra study of short course chemotherapy in pulmonary tuberculous patients: Ind J Tub.1982; 29:29-39.
23. Singapore Tuberculosis Service, BMR Council. Long term follow up of a clinical trial of six-month and four-month regimens of chemotherapy in the treatment of pulmonary tuberculosis. Am Rev Respir Dis 1986; 133: 779–783.8.
24. Hong Kong Chest Service/BMR Council. Controlled trial of 2, 4, and 6 months of pyrazinamide in 6-month, three-times weekly regimens for smear-positive pulmonary tuberculosis, including an assessment of a combined preparation of isoniazid, rifampin, and pyrazinamide: Results at 30 months. Am Rev Respir Dis 1991;143: 700–706.
25. Mohammad Taher, S K Sharma et al. DOTS at a tertiary care centre in northern India: scenario challenges and next step in TB control. Ind J Med Res. 123, May 2006; 702-06.

Dr Ambika Sood

Address: 98, Lower Bazaar, Shimla. Pin-171001, India