Efficacy of twice weekly treatment for tuberculosis given under direct observation in Africa

Wilkinson, David, Anderson, Elizabeth, Davies, Geraint R., Sturm, A. Willem and McAdam, Keith P. W. J. (1997) Efficacy of twice weekly treatment for tuberculosis given under direct observation in Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 91 1: 87-89. doi:10.1016/S0035-9203(97)90407-7


Author Wilkinson, David
Anderson, Elizabeth
Davies, Geraint R.
Sturm, A. Willem
McAdam, Keith P. W. J.
Title Efficacy of twice weekly treatment for tuberculosis given under direct observation in Africa
Journal name Transactions of the Royal Society of Tropical Medicine and Hygiene   Check publisher's open access policy
ISSN 0035-9203
Publication date 1997-01
Sub-type Article (original research)
DOI 10.1016/S0035-9203(97)90407-7
Volume 91
Issue 1
Start page 87
End page 89
Total pages 3
Place of publication London, England
Publisher Elsevier
Language eng
Subject 1103 Clinical Sciences
1108 Medical Microbiology
1117 Public Health and Health Services
Abstract The efficacy of a 6 months course of twice weekly therapy with 4 drugs for tuberculosis, preceded by a 2-3 weeks intensive daily phase, is unknown. Implementation of this regime as community-based directly observed therapy in Africa is highly effective (85% completion rate); it is important to estimate the efficacy of the regime before advocating its widespread use and before conducting prospective trials. We retrospectively evaluated 109 consecutive adults with culture-positive pulmonary tuberculosis who had documented completion of treatment; 84 (77%) were traced and in 15 (14%) a history was obtained from a close relative; 10 (9%) had left the area. Nineteen patients were producing sputum and 4 of these were culture-positive for Mycobacterium tuberculosis, giving an estimated cure rate of 95% (95% confidence interval, 89-98%). Follow-up specimens revealed no acquired drug resistance and restriction fragment length polymorphism analysis of patient-paired specimens showed them to be nearly identical, indicating that treatment had failed or there had been early relapse. This preliminary study suggested that generally twice weekly 4-drug treatment for tuberculosis, given under direct observation, is curative in an acceptable proportion of patients. Prospective trials are indicated.
Keyword Tuberculosis
Mycobacterium Tuberculosis
Chemotherapy
Twice Weekly Treatment
Isoniazid
Rifampicin
Pyrazinamide
Ethambutol
South Africa
Pulmonary Tuberculosis
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, 13:05:43 EST