Seven year findings of short-course chemotherapy in 18 districts in India under district tuberculosis programme

摘要

The ICMR undertook a study project to find out the feasibility of introducing Short-Course Chemotherapy (SCC) under the existing programme conditions and evaluate its acceptability. Sputum positive pulmonary tuberculosis patients aged 15 years or more who had not received more than two months of anti-tuberculosis chemotherapy, belonging to 18 districts spread over 9 states and one union territory of India, were treated with one of the following regimens:ududRegimen 1 : Rifampicin, Isoniazid and Pyrazinamide for 2 months and Rifampicin and Isoniazid for the next 4 months, the drugs being given twice a week under supervision. udRegimen 2 : Rifampicin, Isoniazid and Pyrazinamide daily for 2 months and Thioacetazone and Isoniazid for the next 6 months drugs being self-administered. udRegimen 3 : As in regimen 2 for 2 months and Rifampicin and Isoniazid for the next 4 months, the drugs being given twice a week under supervision.udud In all, a population of 40 million was covered. Of the Peripheral Health Institutions where District Tuberculosis Programme had been implemented, 66% in 1985 and 93% in 1991 had implemented SCC. Of the newly diagnosed patients, 83% were eligible for SCC and 62% of these were started on SCC. Of the remaining patients, with data available, the reasons for not starting SCC were `patient-related' in 58% and had organisational/ administrative related aspects in 35%.udud Of those who were started on SCC, 49% in regimen I, 54% in regimen 2 and 61% in regimen 3 received 80% or more of chemotherapy. Concurrent cohort analysis of SCC and standard regimens showed that the overall treatment completion for SCC was fairly constant (51-55%), but ranged from 29% to 45% for the standard regimen.ududConclusion : It is feasible to employ SCC under the existing programme conditions. However, additional efforts have to be made to improve case finding and case holding further.