title: [Tuberculosis control in Malawi. Time distribution of cessation of treatment and proposals for reorientation of the program].
abstract: In Kasungu district (Malaŵi), the patients with pulmonary tuberculosis are admitted in the district hospital for two months and then referred to the private organization LEPRA for further ambulatory treatment. Out of 73 patients found with positive expectoration for AAFB during 8 months, 54 were actually referred to LEPRA, 4 were sent to another hospital on died, and 15 defaulted. Later on 15% of the patients referred to LEPRA were lost to follow up during one year. 2/3 of defaulting happened during the 2 first months of the treatment. Furthermore the infectious patients case finding rate is likely to be very low. Those observations lead to propose three prioritary actions to improve tuberculosis control: case finding amelioration, relinquishment of compulsory long duration admissions, and integration of the tuberculosis care network into the general health system.
mesh_terms: D000553:Ambulatory Care; D006760:Hospitalization; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D008295:Malawi; D010349:Patient Compliance; D012017:Referral and Consultation; D013307:Streptomycin / Q000008:administration & dosage; D013828:Thioacetazone / Q000008:administration & dosage; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control* / Q000628:therapy
chemical_list: D013828:Thioacetazone; D007538:Isoniazid; D013307:Streptomycin
vernacular_title: Contrôle antituberculeux au Malawi. Répartition dans le temps des abandons de traitement et propositions pour une réorientation du programme.