Field research in humanitarian medical programmes. Treatment of a cohort of tuberculosis patients using the Manyatta regimen in a conflict zone in South Sudan.

Hdl Handle:
http://hdl.handle.net/10144/17296
Title:
Field research in humanitarian medical programmes. Treatment of a cohort of tuberculosis patients using the Manyatta regimen in a conflict zone in South Sudan.
Authors:
Keus, K; Houston, S; Melaku, Y; Burling, S
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
This is a descriptive report of a pilot project of tuberculosis (TB) treatment in a conflict zone. A TB programme was implemented by Médecins Sans Frontières(MSF)-Holland in a semi-nomadic population in a very insecure and underdeveloped area of Upper Nile province in Southern Sudan. Outcome measures were operational feasibility, default rate, and sputum smear conversion at 4 months. A cohort of TB patients was admitted over a 10-week period (July-September 2001). Adherence strategy, project implementation, and and contingency planning were adapted to local conditions. The treatment regimen (4 HRZE [4-month daily supervised regimen] followed by 3EH or 3TH [3-month unsupervised regimen]: isoniazid (H), rifampicin (R), pyrazinamide (Z), ethambutol (E) and thiacetazone (T)) was a variant on the Manyatta regimen developed for semi-nomads in Kenya. Of 163 patients, 84 (52%) were children aged < 15 years. Lymph node TB comprised 34% and spinal TB 15% of all patients. Among adults, 41% had smear-positive pulmonary disease. Only 1 patient (0.6%) defaulted. All sputum smear-positive patients who completed 4 months of therapy converted to smear-negative, although 2 were subsequently found to have relapsed. TB in complex emergency situations is an underrecognized priority. Using an approach adapted especially to this setting, TB treatment was successfully implemented with minimal risk of promoting drug resistance, in an unstable setting.
Affiliation:
Médecins Sans Frontières-Holland, Max Euweplein 40, PO Box 10014, 1001 EA Amsterdam, The Netherlands.
Publisher:
Elsevier
Issue Date:
31-Jan-2008
URI:
http://hdl.handle.net/10144/17296
PubMed ID:
16134258
Additional Links:
http://www.sciencedirect.com/science/journal/00359203
Language:
en
ISSN:
0035-9203
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorKeus, K-
dc.contributor.authorHouston, S-
dc.contributor.authorMelaku, Y-
dc.contributor.authorBurling, S-
dc.date.accessioned2008-01-31T17:05:01Z-
dc.date.available2008-01-31T17:05:01Z-
dc.date.issued2008-01-31T17:05:01Z-
dc.identifier.citationField research in humanitarian medical programmes. Treatment of a cohort of tuberculosis patients using the Manyatta regimen in a conflict zone in South Sudan., 97 (6):614-8 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid16134258-
dc.identifier.urihttp://hdl.handle.net/10144/17296-
dc.description.abstractThis is a descriptive report of a pilot project of tuberculosis (TB) treatment in a conflict zone. A TB programme was implemented by Médecins Sans Frontières(MSF)-Holland in a semi-nomadic population in a very insecure and underdeveloped area of Upper Nile province in Southern Sudan. Outcome measures were operational feasibility, default rate, and sputum smear conversion at 4 months. A cohort of TB patients was admitted over a 10-week period (July-September 2001). Adherence strategy, project implementation, and and contingency planning were adapted to local conditions. The treatment regimen (4 HRZE [4-month daily supervised regimen] followed by 3EH or 3TH [3-month unsupervised regimen]: isoniazid (H), rifampicin (R), pyrazinamide (Z), ethambutol (E) and thiacetazone (T)) was a variant on the Manyatta regimen developed for semi-nomads in Kenya. Of 163 patients, 84 (52%) were children aged < 15 years. Lymph node TB comprised 34% and spinal TB 15% of all patients. Among adults, 41% had smear-positive pulmonary disease. Only 1 patient (0.6%) defaulted. All sputum smear-positive patients who completed 4 months of therapy converted to smear-negative, although 2 were subsequently found to have relapsed. TB in complex emergency situations is an underrecognized priority. Using an approach adapted especially to this setting, TB treatment was successfully implemented with minimal risk of promoting drug resistance, in an unstable setting.en
dc.language.isoenen
dc.publisherElsevier-
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203-
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAltruismen
dc.subject.meshAntitubercular Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCohort Studiesen
dc.subject.meshDrug Combinationsen
dc.subject.meshFeasibility Studiesen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPilot Projectsen
dc.subject.meshSputumen
dc.subject.meshSudanen
dc.subject.meshTuberculosisen
dc.subject.meshWaren
dc.titleField research in humanitarian medical programmes. Treatment of a cohort of tuberculosis patients using the Manyatta regimen in a conflict zone in South Sudan.en
dc.contributor.departmentMédecins Sans Frontières-Holland, Max Euweplein 40, PO Box 10014, 1001 EA Amsterdam, The Netherlands.en
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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