Immunotherapy with Mycobacterium vaccae as an addition to chemotherapy for the treatment of pulmonary tuberculosis under difficult conditions in Africa.
A study to assess the impact of immunotherapy with Mycobacterium vaccae on the treatment of pulmonary tuberculosis was conducted under existing conditions in Kano, a large city in Northern Nigeria. Whilst it did not quite meet all the criteria of a well-controlled randomized or double-blind trial, the study produced results suggestive of a successful intervention. Immunotherapy with M. vaccae had a beneficial influence on clinical recovery and survival, whether given after 1, 2 or 3 weeks of chemotherapy, according to an assessment made 10-14 months after treatment. Approximately 3 weeks (19.8 days) after the onset of chemotherapy (SHRZ), 73% of the patients who received immunotherapy and 19% of those who received placebo (chemotherapy alone) had become sputum negative by microscopy for acid-fast bacilli (AFB). Similarly, a mean fall in erythrocyte sedimentation rate (ESR) of 25.4 +/- 2.50 mm and 4.0 +/- 2.29 mm was observed in the immunotherapy and placebo recipients respectively, at the same time of assessment. When weight was assessed in the two groups, it was observed that 3 weeks after starting chemotherapy, the recipients of immunotherapy had a mean weight gain of 2.90 +/- 0.24 kg whilst placebo recipients had a mean weight gain of only 0.55 +/- 0.17 kg. These parameters were re-evaluated, 10-14 months later. They showed that 11% of the recipients of the active intervention and 84.6% of placebo recipients still had demonstrable AFB in their sputum. The mean weight gain had increased to 7.91 +/- 1.03 kg and 2.04 +/- 0.94 kg in the immunotherapy and placebo recipients respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Onyebujoh
P C
PC
Department of Medical Microbiology, University College London Medical School.
Abdulmumini
T
T
Robinson
S
S
Rook
G A
GA
Stanford
J L
JL
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D016233:Immunotherapy, Active; D008875:Middle Aged; D009161:Mycobacterium / Q000276:immunology*; D009549:Nigeria; D010349:Patient Compliance; D016037:Single-Blind Method; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000401:mortality / Q000628:therapy*
D000995:Antitubercular Agents