Management and outcome of tuberculosis patients who fail treatment under routine programme conditions in Malawi


Harries, AD; Nyirenda, TE; Kemp, JR; Squire, BS; Godfrey-Faussett, P; Salaniponi, FML; (2003) Management and outcome of tuberculosis patients who fail treatment under routine programme conditions in Malawi. The international journal of tuberculosis and lung disease, 7 (11). pp. 1040-4. ISSN 1027-3719

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Abstract

SETTING: All 43 non-private hospitals (three central, 22 district and 18 mission) in Malawi that registered and treated TB cases between 1 July 1999 and 30 June 2000. OBJECTIVES: To determine 1) the number of new smear-positive PTB patients who failed treatment, 2) the management of patients who failed, 3) their treatment outcome and 4) culture and drug sensitivity results. DESIGN: Retrospective data collection using TB registers and laboratory culture and drug sensitivity registers. RESULTS: Ninety patients failed treatment, 60 (67%) at 5 months and 30 (33%) at the end of treatment. Sixty-four (71%) failure patients were registered and commenced on anti-tuberculosis treatment. Of these, 95% were registered in the same hospital as before, 89% were given a different TB registration number, 67% were correctly registered as 'failures' and 61% were treated within one month of failing the previous regimen. Forty-eight (75%) re-treated patients were cured. Only 31 (34%) of the 90 patients had sputum sent for culture and drug sensitivity testing. In 11 patients with cultures of M. tuberculosis, eight were fully sensitive and three had mono-resistance to isoniazid. CONCLUSION: While the outcome of failure patients who start retreatment is good, there are several programmatic deficiencies that need to be corrected.

Item Type: Article
Keywords: anti-tuberculosis treatment, failure, Malawi, Short-course chemotherapy, resistance
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Malaria Centre
PubMed ID: 14598962
Web of Science ID: 186222600005
URI: http://researchonline.lshtm.ac.uk/id/eprint/15698

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