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Free Content Six- vs. eight-month anti-tuberculosis regimen for pulmonary tuberculosis under programme conditions

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SETTING: One urban tertiary care and one rural secondary care hospital in Nigeria.

OBJECTIVE: To compare the epidemiological characteristics and treatment outcomes of tuberculosis (TB) patients treated with an 8-month or 6-month anti-tuberculosis regimen in a low-resource setting.

DESIGN: Retrospective cohort study.

RESULTS: A total of 928 newly diagnosed smear-positive TB patients were treated with either daily ethambutol (EMB), isoniazid (INH), rifampicin (RMP) and pyrazinamide (PZA) for 2 months followed by EMB and INH for 6 months (2RHZE/6EH), or the same intensive phase as the first regimen followed by 4 months of daily RMP and INH (2RHZE/4RH). The proportion of successful outcomes was 381/490 (77.8%) with 2RHZE/6EH and 373/438 (85.2%) with 2RHZE/4RH (P = 0.004). Defaulting was significantly more frequent in patients who received 2RHZE/6EH (14.3% vs. 5.5%; P < 0.001). Treatment failure was not significantly higher in patients who received 2RHZE/6EH (2.9% vs. 1.6%; P = 0.15). After adjusting for confounders, older age (adjusted odds ratio [aOR] 1.7), 2RHZE/6EH treatment (aOR 1.6) and male sex (aOR 1.5) independently predicted unsuccessful outcomes in human immunodeficiency virus negative TB patients.

CONCLUSIONS: Newly diagnosed TB patients on 2RHZE/4RH have a higher treatment success rate than those treated with 2RHZE/6EH under programme conditions in a low-resource, high-burden setting. Current World Health Organization recommendations should be maintained.
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Keywords: 8-month treatment regimen; Nigeria; shorter regimen; treatment success; tuberculosis outcomes

Document Type: Research Article

Affiliations: 1: *Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Ebonyi State 2: Centre for Development and Reproductive Health, Enugu, Enugu State 3: National Tuberculosis and Leprosy Control Programme, Ministry of Health, Abakaliki, Ebonyi State, Nigeria

Publication date: 01 March 2015

More about this publication?
  • 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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