Recurrent tuberculosis: definitions and treatment regimens.
Within the National Tuberculosis Control Programme of Malawi, misunderstandings sometimes occur about the diagnosis and management of recurrent tuberculosis (TB). Patients with smear-positive pulmonary tuberculosis (PTB) who have had a previous, treated episode of smear-negative TB may be registered as 'new cases' rather than relapse cases, and thus denied the benefits of a retreatment regimen. Patients with a recurrent episode of smear-negative PTB or extra-pulmonary TB (EPTB) may also be wrongly registered as 'new cases' rather than recurrent cases. International guidelines about the treatment of recurrent smear-negative PTB and EPTB are not explicit, resulting in confusion about how best to manage these cases. It is suggested that all such cases be considered for re-treatment regimen because of concerns about acquired drug resistance. WHO and IUATLD guidelines on the diagnosis and management of recurrent and relapse TB need to be improved, and operational research studies should be conducted to provide answers to some outstanding questions.
Harries
A D
AD
National Tuberculosis Control Programme, Ministry of Health, Lilongwe, Malawi.
Hargreaves
N J
NJ
Kwanjana
J H
JH
Salaniponi
F M
FM
D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D008295:Malawi; D017410:Practice Guidelines as Topic; D012008:Recurrence; D019233:Retreatment; D009626:Terminology as Topic; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents