Is oral intermittent initial phase anti-tuberculosis treatment associated with higher mortality in high HIV-prevalent areas in sub-Saharan Africa?
The Malawi Tuberculosis Programme has evaluated an oral ambulatory treatment regimen (2R3H3Z3E3/6HE) in five districts, and observed a mortality rate of 23% in 2671 new patients with smear-positive pulmonary tuberculosis (PTB). Three studies were performed comparing treatment outcomes between patients treated with 2R3H3Z3E3/6HE and 2SRHZ/6HE using historical data in the same districts and concurrent data in different districts. Using historical comparisons, mortality was significantly higher with 2R3H3Z3E3/6HE than 2SRHZ/6HE. Using concurrent comparisons, mortality was similar, although there was a higher death rate in the first month with the intermittent regimen. The intermittent regimen may be inferior to the established regimen.
Harries
A D
AD
National Tuberculosis Control Programme, Ministry of Health, Lilongwe, Malawi. adharries@malawi.net
Gausi
F K
FK
Kwanjana
J H
JH
Nyirenda
T E
TE
Salaniponi
F M
FM
D017954:Africa South of the Sahara / Q000453:epidemiology; D000995:Antitubercular Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D006801:Humans; D010507:Periodicity; D012306:Risk; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000401:mortality
D000995:Antitubercular Agents