Two-year follow-up of directly-observed intermittent regimens for smear-positive pulmonary tuberculosis in China

• Published in: The international journal of tuberculosis and lung disease Vol. 2; no. 5; pp. 360 - 364
• Main Authors: CAO, J. P, ZHANG, L. Y, ZHU, J. Q, CHIN, D. P
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.05.1998; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Antitubercular Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Cause of Death; China; Directly-Observed Therapy; Follow-Up Studies; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Mortality; Mycobacterium tuberculosis - isolation & purification; Recurrence; Relapse; Sputum - microbiology; Survival Analysis; Treat; Tuberculosis; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - mortality; Tuberculosis, Pulmonary - prevention & control; Asia; China; Human; Lung disease; Relapse; Respiratory disease; Mongoloid; Mortality; Lung; Mycobacterial infection; Infection; Chemotherapy; Treatment; Tuberculosis; Follow up study; Bacteriosis; Antituberculous agent; Public health
• ISSN: 1027-3719; 1815-7920

Setting: The tuberculosis component of the Infectious and Endemic Disease Control Project in the People's Republic of China is the largest single tuberculosis control project in the world using directly-observed therapy and standardized intermittent regimens.Objective: To determine the two-year relapse and mortality rates following completion of treatment.Design: A prospective cohort study of 649 cases cured in this project. The 306 new and 343 retreatment cases were treated under field conditions with 2H3R3Z3S3/4H3R3 and 2H3R3Z3E3S3/6H3R3E3, respectively. Following treatment completion, two sputum samples were collected every six months for two years and examined for acid-fast bacilli. Causes of death were identified.Results: The two-year relapse rates for new and retreatment cases were 3.3% and 5.6%, respectively. Retreatment cases with delayed sputum conversion had a greater risk for subsequent relapse. The two-year mortality rate for new and retreatment cases was 3.3% and 8.5%, respectively. The higher mortality rate in retreatment cases was not attributable to relapse of disease, but rather to non-infectious sequelae of tuberculosis.Conclusion: The use of directly-observed intermittent regimens is effective in permanently removing infectious tuberculosis cases from the community.