VK Dhingra, MB, BS¹, Deepak Kalra, MB, BS², and Sanjay Rajpal, MB, BS¹. (1) New Delhi Tuberculosis Center, Jawahar Lal Nehru Marg, New Delhi, 110032, India, (2) MPH (Quantitative Methods), Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, 8572047301, dkalra@hsph.harvard.edu

India, with seventh largest land size (2%) and a population of 1.2 billion (15%), next only to China, has a disproportionately higher 0global burden of Tuberculosis(30%), which it hopes to control by mounting World’s second largest DOTS (Directly Observed Treatment Short-Course) programme – the best proven means of TB control. Each year 1 million smear positive, and 2 million total new cases occur while annual mortality is 0.45 million. DOTS has achieved significant success in most parts of the country where it has been introduced in the adult age group under the Revised National Tuberculosis Programme, but it’s success in children and adolescents attending the programme and the outcome is being questioned.

At New Delhi TB Center, which is the TB Clinic of a tertiary teaching hospital of University of Delhi, we noticed a lack of patients from under-18 age group, which we decided to investigate after finding a paucity of studies in the literature. A Retrospective Analysis of Data was done for patients attending the clinic in the last 5 years. Attendance in the below-18 years was found to be significantly lower than expected and percentage of pulmonary TB was less when compared with adults attending the clinic. We think this may be due to the fact that DOTS clinics run during school hours making it difficult for students to attend the clinic.

We recommend evening hours for DOTS clinics or Drug administration by School Health Nurse and massive health education to avoid discrimination and social stigmatization in schools.

Learning Objectives:

• Familarise the attendees with WHO's DOTS programme for Tuberculosis in developing countries
• Discuss the Shortcomings of the Programme in the under-18 year age group in spite of significant success in adults and their possible reasons.
• Through interaction with attendees, discuss and device possible solutions.
• Encourage similar studies by making participants ponder over the problem, and it's implications for the younger age groups in other developing countries where DOTS is being rigourously implemented.

Keywords: Tuberculosis, Developing Countries

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.