Tuberculosis treatment outcome monitoring: Blackburn 1988-2000.
METHODS
All cases of tuberculosis in a high prevalence district (population 269,000) of England.


OBJECTIVE
To analyse the tuberculosis programme outcome for confirmed pulmonary tuberculosis, and all other categories of cases for 1988-2000 inclusive.


METHODS
The outcome of all cases treated during the period 1988-2000 inclusive was assessed by agreed European outcome criteria, retrospectively for 1988-1998 and prospectively for 1999-2000.


RESULTS
A total of 729 tuberculosis cases were notified, with 209 definite (culture-positive) pulmonary cases. Of the 205 definite pulmonary cases treated in life, 182 received self-administered treatment (SAT) and 23 directly observed treatment (DOT), with an 88% cure/completion rate and a 12% death rate. The relapse rate for SAT was 1/182 (0.5%) and 1/23 for DOT (4.3%). The cure/completion rate for all patients together was 94.3%, with a relapse rate of 0.8%.


CONCLUSIONS
In this resource-rich setting, treatment largely by SAT, but carefully monitored, gives a very high cure/completion rate. Universal rather than selective DOT would make little additional impact on patient outcome. These outcomes are not likely to be reproducible, however, with SAT in a resource-poor setting.
Ormerod
L P
LP
Chest Clinic, Blackburn Royal Infirmary, Lancs, UK.
Horsfield
N
N
Green
R M
RM
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D023801:Directly Observed Therapy; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012646:Self Administration; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents