Compliance with cotrimoxazole prophylaxis for the prevention of opportunistic infections in HIV-positive tuberculosis patients in Thyolo district, Malawi
DESIGN: Cross-sectional study.
METHODS: Cotrimoxazole compliance was assessed in a cohort of TB patients who were attending four TB follow-up centres during the continuation phase of anti-TB treatment between months 4 and 6. Verbal verification of drug intake, physical verification of pill count balance, and urine trimethoprim detection by gas chromatography and mass spectrometry were used for assessing compliance.
RESULTS: Using urine trimethoprim detection as the gold standard for compliance, trimethoprim was detected in 82 (94%) of 87 patients in the cohort. Verbal verification of cotrimoxazole intake and objective pill count balances showed high sensitivity and positive predictive values compared with the gold standard of urine trimethoprim detection.
CONCLUSIONS: In a rural district in Malawi, compliance with cotrimoxazole as an adjunct to anti-tuberculosis treatment in HIV-infected TB patients was good, and can be assessed simply and practically by verbal verification and pill counts.
Document Type: Regular Paper
Affiliations: 1: Medecins sans Frontieres-Luxembourg, Thyolo District, Malawi 2: National Tuberculosis Control Programme, Malawi 3: Department of Infectious Diseases, Central Reference Hospital, Luxembourg 4: Department of Toxicology, National Laboratory of Health, University Center, Luxembourg
Publication date: 2001-09-01
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