Treatment outcome of patients with smear-negative and smear-positive pulmonary tuberculosis in the National Tuberculosis Control Programme, Malawi.

Hdl Handle:
http://hdl.handle.net/10144/37472
Title:
Treatment outcome of patients with smear-negative and smear-positive pulmonary tuberculosis in the National Tuberculosis Control Programme, Malawi.
Authors:
Harries, A D; Nyirenda, T E; Banerjee, A; Boeree, M J; Salaniponi, F M L
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
National tuberculosis control programmes (NTPs) in sub-Saharan Africa do not routinely record or report treatment outcome data on smear-negative pulmonary tuberculosis (PTB) patients. Twelve-month treatment outcome on patients with smear-negative PTB registered in all district and mission hospitals in Malawi during the year 1995 was collected, and was compared with 8-month treatment outcome in smear-positive PTB patients registered during the same period. Of 4240 patients with smear-negative PTB, 35% completed treatment, 25% died, 9% defaulted and 7% were transferred to another district with no treatment outcome results available. In 24% of patients treatment cards were lost and treatment outcome was unknown. These results were significantly inferior to those obtained in 4003 patients with smear-positive PTB in whom 72% completed treatment, 20% died, 4% defaulted, 2% were transferred and 1% had positive smears at the end of treatment. These differences between patients with smear-negative and smear-positive PTB were similar when analysed by sex and by most age-groups. Higher mortality rates in patients with smear-negative PTB are probably attributable to advanced HIV-related immunosuppression, and higher default and treatment unknown rates probably reflect the lack of attention paid by TB programme staff to this group of patients. As a result of this country-wide study the Malawi NTP has started to record routinely the treatment outcomes of smear-negative TB patients and has set treatment completion targets of 50% or higher for this group of patients.
Affiliation:
National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi. epicentre@imul.com
Publisher:
Elsevier and the Royal Society of Tropical Medicine and Hygiene
Issue Date:
1999
URI:
http://hdl.handle.net/10144/37472
PubMed ID:
10674100
Language:
en
ISSN:
0035-9203
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorHarries, A D-
dc.contributor.authorNyirenda, T E-
dc.contributor.authorBanerjee, A-
dc.contributor.authorBoeree, M J-
dc.contributor.authorSalaniponi, F M L-
dc.date.accessioned2008-09-08T09:19:27Z-
dc.date.available2008-09-08T09:19:27Z-
dc.date.issued1999-
dc.identifier.citationTreatment outcome of patients with smear-negative and smear-positive pulmonary tuberculosis in the National Tuberculosis Control Programme, Malawi., 93 (4):443-6 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid10674100-
dc.identifier.urihttp://hdl.handle.net/10144/37472-
dc.description.abstractNational tuberculosis control programmes (NTPs) in sub-Saharan Africa do not routinely record or report treatment outcome data on smear-negative pulmonary tuberculosis (PTB) patients. Twelve-month treatment outcome on patients with smear-negative PTB registered in all district and mission hospitals in Malawi during the year 1995 was collected, and was compared with 8-month treatment outcome in smear-positive PTB patients registered during the same period. Of 4240 patients with smear-negative PTB, 35% completed treatment, 25% died, 9% defaulted and 7% were transferred to another district with no treatment outcome results available. In 24% of patients treatment cards were lost and treatment outcome was unknown. These results were significantly inferior to those obtained in 4003 patients with smear-positive PTB in whom 72% completed treatment, 20% died, 4% defaulted, 2% were transferred and 1% had positive smears at the end of treatment. These differences between patients with smear-negative and smear-positive PTB were similar when analysed by sex and by most age-groups. Higher mortality rates in patients with smear-negative PTB are probably attributable to advanced HIV-related immunosuppression, and higher default and treatment unknown rates probably reflect the lack of attention paid by TB programme staff to this group of patients. As a result of this country-wide study the Malawi NTP has started to record routinely the treatment outcomes of smear-negative TB patients and has set treatment completion targets of 50% or higher for this group of patients.en
dc.language.isoenen
dc.publisherElsevier and the Royal Society of Tropical Medicine and Hygieneen
dc.rightsPublished by Elsevier. Archived on this site with the kind permission of Elsevier Ltd. ([url]http://www.sciencedirect.com/science/journal/00359203[/url]) and the Royal Society of Tropical Medicine and Hygiene ([url]http://www.rstmh.org/transactions.asp[/url])en
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAntitubercular Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshFemaleen
dc.subject.meshHealth Surveysen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshMalawien
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshSurvival Analysisen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTuberculosis, Pulmonaryen
dc.titleTreatment outcome of patients with smear-negative and smear-positive pulmonary tuberculosis in the National Tuberculosis Control Programme, Malawi.en
dc.contributor.departmentNational Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi. epicentre@imul.comen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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