Document 0947
 DOCN  M9620947
 TI    Impact of the change from an injectable to a fully oral regimen on
       patient adherence to ambulatory tuberculosis treatment in Dar es Salaam,
       Tanzania.
 DT    9602
 AU    Chum HJ; Ilmolelian G; Rieder HL; Msangi J; Mwinyi N; Zwahlen M; Enarson
       DA; Ipuge YA; Tanzania National Tuberculosis/Leprosy Programme, Ministry
       of; Health, Dar es Salaam, Tanzania.
 SO    Tuber Lung Dis. 1995 Aug;76(4):286-9. Unique Identifier : AIDSLINE
       MED/96048190
 AB    OBJECTIVE: To measure the impact on patient adherence to directly
       observed ambulatory tuberculosis treatment substituting an all-oral
       treatment regimen for a regimen containing streptomycin. METHODS: The
       expected and observed attendance of patients during the intensive phase
       of anti-tuberculosis treatment was measured daily at two out-patient
       clinics in Dar es Salaam. During the observation period, treatment was
       changed from a regimen containing streptomycin to an all-oral regimen,
       and attendance proportions were compared for the three periods during
       which patients always, sometimes or never received streptomycin during
       the intensive phase of treatment. RESULTS: In Kinondoni, an average of
       98 patients was expected every day, in Ilala 127. No significant
       difference was observed in attendance in Kinondoni between periods when
       patients always (median attendance 95.9%) and never (median 95.7%)
       received streptomycin injections as part of their intensive phase
       treatment for tuberculosis. In Ilala, no difference was noted in
       attendance between the period in which patients received streptomycin
       for at least part of their treatment (median 91.3%) and the period when
       ethambutol had fully replaced streptomycin (median 91.8%). CONCLUSIONS:
       In these two districts of Dar es Salaam, patient adherence to a
       completely oral treatment regimen was indistinguishable from that to a
       streptomycin-containing regimen. Given the potential of iatrogenic
       transmission of HIV and the advantages in reduced staff time and drug
       costs, the results clearly justify the replacement of streptomycin with
       ethambutol in Tanzania for new patients receiving an ambulatory
       rifampicin-containing regimen.
 DE    Administration, Oral  *Ambulatory Care  Antitubercular
       Agents/*ADMINISTRATION & DOSAGE  Comparative Study
       Ethambutol/ADMINISTRATION & DOSAGE  Human  Injections, Intramuscular
       *Patient Compliance  Streptomycin/ADMINISTRATION & DOSAGE  Tanzania
       Tuberculosis/*DRUG THERAPY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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