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Free Content Tuberculosis treatment outcome monitoring: Blackburn 1988–2000

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Abstract:

SETTING: All cases of tuberculosis in a high prevalence district (population 269000) of England.

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

DESIGN: 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%.

CONCLUSION: 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 reproduceable, however, with SAT in a resource-poor setting.

Keywords: DOT; United Kingdom; outcome; treatment; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Chest Clinic, Blackburn Royal Infirmary, Blackburn, UK; and Lancashire Postgraduate School of Medicine and Health, University of Central Lancashire, Preston, Lancashire, UK 2: Chest Clinic, Blackburn Royal Infirmary, Blackburn, Lancashire, UK

Publication date: 2002-08-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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