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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 on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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