Tuberculosis treatment in complex emergencies: are risks outweighing benefits?

Hdl Handle:
http://hdl.handle.net/10144/39578
Title:
Tuberculosis treatment in complex emergencies: are risks outweighing benefits?
Authors:
Biot, M; Chandramohan, D; Porter, J D H
Journal:
Tropical Medicine & International Health
Abstract:
Tuberculosis (TB) is a major public health problem in complex emergencies. Humanitarian agencies usually postpone the decision to offer TB treatment and opportunities to treat TB patients are often missed. This paper looks at the problem of tuberculosis treatment in these emergencies and questions whether treatment guidelines could be more flexible than international recommendations. A mathematical model is used to calculate the risks and benefits of different treatment scenarios with increasing default rates. Model outcomes are compared to a situation without treatment. An economic analysis further discusses the findings in a trade-off between the extra costs of treating relapses and failures and the savings in future treatment costs. In complex emergencies, if a TB programme could offer 4-month treatment for 75% of its patients, it could still be considered beneficial in terms of public health. In addition, the proportion of patients following at least 4 months of treatment can be used as an indicator to help evaluate the public health harm and benefit of the TB programme.
Affiliation:
MSF Brussels
Issue Date:
Mar-2003
URI:
http://hdl.handle.net/10144/39578
PubMed ID:
12631310
Language:
en
ISSN:
1360-2276
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorBiot, M-
dc.contributor.authorChandramohan, D-
dc.contributor.authorPorter, J D H-
dc.date.accessioned2008-10-24T12:42:18Z-
dc.date.available2008-10-24T12:42:18Z-
dc.date.issued2003-03-
dc.identifier.citationTuberculosis treatment in complex emergencies: are risks outweighing benefits? 2003, 8 (3):211-8 Trop. Med. Int. Healthen
dc.identifier.issn1360-2276-
dc.identifier.pmid12631310-
dc.identifier.urihttp://hdl.handle.net/10144/39578-
dc.description.abstractTuberculosis (TB) is a major public health problem in complex emergencies. Humanitarian agencies usually postpone the decision to offer TB treatment and opportunities to treat TB patients are often missed. This paper looks at the problem of tuberculosis treatment in these emergencies and questions whether treatment guidelines could be more flexible than international recommendations. A mathematical model is used to calculate the risks and benefits of different treatment scenarios with increasing default rates. Model outcomes are compared to a situation without treatment. An economic analysis further discusses the findings in a trade-off between the extra costs of treating relapses and failures and the savings in future treatment costs. In complex emergencies, if a TB programme could offer 4-month treatment for 75% of its patients, it could still be considered beneficial in terms of public health. In addition, the proportion of patients following at least 4 months of treatment can be used as an indicator to help evaluate the public health harm and benefit of the TB programme.en
dc.language.isoenen
dc.rightsArchived on this site with the kind permission of Wiley-Blackwell, [url]http://www.blackwell-synergy.com/loi/tmi[/url]en
dc.subject.meshAntitubercular Agentsen
dc.subject.meshDrug Resistance, Bacterialen
dc.subject.meshEmergenciesen
dc.subject.meshHealth Care Costsen
dc.subject.meshHumansen
dc.subject.meshModels, Theoreticalen
dc.subject.meshPatient Complianceen
dc.subject.meshProgram Evaluationen
dc.subject.meshPublic Healthen
dc.subject.meshRelief Worken
dc.subject.meshRisk Assessmenten
dc.subject.meshTreatment Failureen
dc.subject.meshTuberculosis, Pulmonaryen
dc.subject.meshWaren
dc.titleTuberculosis treatment in complex emergencies: are risks outweighing benefits?en
dc.contributor.departmentMSF Brusselsen
dc.identifier.journalTropical Medicine & International Healthen

Related articles on PubMed

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.