Directly observed therapy for tuberculosis given twice weekly in the workplace in urban South Africa

Bechan, Sudharshanie, Connolly, Catherine, Short, G. Murray, Standing, Elizabeth and Wilkinson, David (1997) Directly observed therapy for tuberculosis given twice weekly in the workplace in urban South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 91 6: 704-707. doi:10.1016/S0035-9203(97)90532-0


Author Bechan, Sudharshanie
Connolly, Catherine
Short, G. Murray
Standing, Elizabeth
Wilkinson, David
Title Directly observed therapy for tuberculosis given twice weekly in the workplace in urban South Africa
Journal name Transactions of the Royal Society of Tropical Medicine and Hygiene   Check publisher's open access policy
ISSN 0035-9203
Publication date 1997-11
Sub-type Article (original research)
DOI 10.1016/S0035-9203(97)90532-0
Volume 91
Issue 6
Start page 704
End page 707
Total pages 4
Place of publication London, England
Publisher Elsevier
Language eng
Subject 1103 Clinical Sciences
1108 Medical Microbiology
1117 Public Health and Health Services
Abstract Effective models of delivery of directly observed therapy (DOT) for tuberculosis in resource-poor settings are needed. Intermittent chemotherapy may be an important component of DOT delivered in the community as it means fewer visits to supervisors. There is no published evidence on the efficacy of twice weekly therapy given from the start of treatment without an intensive daily phase. We analysed data from 3 large cohort studies in a migrant, urban workforce in South Africa between 1975 and 1983. All patients received 4 drugs (isoniazid, rifampicin, pyrazinamide and streptomycin) twice weekly under direct observation by a nurse in the workplace. Of 444 patients, 378 (85.1%) completed treatment. Cure could be assessed in 362, and 348 (96.1%, 95% confidence interval 93.7-97.8%) were bacteriologically cured. Sputum status was assessed at 2-3 months in 343 patients and 309 (90.1%) were sputum negative. Eighteen patients relapsed (5.7%; 2.9/100 patient-years of observation). DOT can be effectively delivered to a migrant, urban workforce, and 4-drug therapy given twice weekly under direct observation is efficacious.
Keyword Tuberculosis
Mycobacterium Tuberculosis
Chemotherapy
Directly Observed Therapy
Isoniazid
Rifampicin
Pyrazinamide
Streptomycin
Pulmonary Tuberculosis
Countries
HIV
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 07 Sep 2010, 13:00:23 EST