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Open Access Changing from single-drug to fixed-dose combinations: experience from Fiji

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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.

Conclusion: The introduction of FDCs in Fiji for the treatment of TB cases has not been associated with changes in treatment response.
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Keywords: Fiji; fixed-dose combination; treatment outcomes; tuberculosis

Document Type: Research Article

Affiliations: 1: National Tuberculosis Programme, Ministry of Health, Suva, Fiji 2: 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

Publication date: September 21, 2014

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

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