Feasibility study of a district tuberculosis control programme with an 8-month short-course chemotherapy regimen utilizing the integrated health service network under field conditions in Nepal.
METHODS
Tuberculosis in Nepal has not been controlled; there is an annual risk of infection of more than 2%, a cure rate of 30-40% and a casefinding rate of 40%. The necessity of a pilot programme with short-course chemotherapy that could be applied across the nation was discussed, and an operational research project utilizing the existing basic health service network was launched.


OBJECTIVE
The main objective was to assess the feasibility of integrating a tuberculosis programme into the basic health services under various field conditions, and of introducing an 8-month short-course chemotherapy regimen instead of the 12-month standard regimen.


METHODS
A tuberculosis control programme package based on the current international strategy was introduced in Dhading and Chitawan districts (population 650,000) in 1990. The reported results were confirmed by central supervision and a follow-up study.


RESULTS
454 new smear-positive cases were found in the first year. 69% were cured and 9% completed their treatment. However an 85% completion rate could be expected from the results of the follow-up study.


CONCLUSIONS
An integrated tuberculosis control programme with short-course chemotherapy is feasible. An adequate supply of drugs and supervision are vital components. The results showed the possibility of achieving the international target of an 85% cure rate and 70% detection, even within the constraints of the field conditions in Nepal.
Onozaki
I
I
National Tuberculosis Centre, Kathmandu, Nepal.
Shakya
T M
TM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents / Q000008:administration & dosage; D002648:Child; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D010352:Patient Dropouts; D012041:Regional Medical Programs / Q000458:organization & administration*; D014376:Tuberculosis / Q000188:drug therapy / Q000517:prevention & control*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents