title: Study of a fully supervised programme of chemotherapy for pulmonary tuberculosis given once weekly in the continuation phase in the rural areas of Hong Kong.
abstract: In the rural areas of Hong Kong outpatient treatment is organised from general primary health-care clinics which are visited only once a week by chest clinic staff. A daily 18-month, self-administered regimen of isoniazid and sodium PAS supplemented by daily streptomycin injections for the first 3 months has been the standard regimen, the patients attending a clinic once a month to collect their oral drugs, even during the first 3 months. In 1979 a new rural service programme of fully supervised chemotherapy was introduced for a trial period of 1 year. Patients were to be admitted to hospital initially for up to 2 months for daily treatment with streptomycin, isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by once-weekly streptomycin, isoniazid, rifampicin, and ethambutol up to 12 months, fully supervised in the primary health-care clinics. The therapeutic results achieved with this new regimen were excellent. Among 101 patients with ne or more positive sputum smears or cultures and 24 with all their smears and cultures negative pretreatment, who were assessable up to 30 months, there were no bacteriological failures during chemotherapy and only one bacteriological relapse after stopping. However, the regimen had a major operational defect in that 41% of the 263 patients treated during the year had to be prescribed standard chemotherapy, which was not fully supervised, instead of the study regimen, 37% because they refused an initial period of hospital admission. The therapeutic results were far less satisfactory with the standard regimen.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012424:Rural Population; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents