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1996-02-26
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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
protected by Copyright Law (Title 17, U.S.Code).