title: Changing from single-drug to fixed-dose combinations: experience from Fiji.
abstract: BACKGROUND
  Fixed-dose combinations (FDCs) of first-line anti-tuberculosis drugs were introduced in Fiji in 2011, and there have been concerns about treatment response.
  
  
  OBJECTIVE
  To evaluate the treatment response to FDCs among tuberculosis (TB) patients.
  
  
  METHODS
  A retrospective cohort study was undertaken of treatment outcomes of new TB cases registered from January 2010 to April 2013 and weighing ⩾30 kg. Sputum smear conversion of new sputum smear-positive cases and end-of-treatment outcomes of all cases were evaluated for those receiving FDCs and compared to outcomes with previous use of single-drug preparations.
  
  
  RESULTS
  Among new TB patients, 240 received single-drug preparations and 259 received FDCs for the full duration of treatment. The groups were similar in terms of demographic and clinical characteristics. Treatment outcomes were available for 95% of cases. Unknown outcomes were more common in those receiving FDCs. When known, end-of-treatment outcome was the same in the two treatment groups and did not differ between TB types. Sputum smear conversion after the 2-month intensive phase of treatment was similar in the two treatment groups: 95% and 97%, respectively.
  
  
  CONCLUSIONS
  The introduction of FDCs in Fiji for the treatment of TB cases has not been associated with changes in treatment response.
authors.affiliation: National Tuberculosis Programme, Ministry of Health, Suva, Fiji.
authors.forename: R
authors.initials: R
authors.lastname: Mahadeo
authors.affiliation: National Tuberculosis Programme, Ministry of Health, Suva, Fiji.
authors.forename: S
authors.initials: S
authors.lastname: Gounder
authors.affiliation: Centre for International Child Health, University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia ; International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: S M
authors.initials: SM
authors.lastname: Graham
keywords: Fiji; fixed-dose combination; treatment outcomes; tuberculosis