The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
-
Int. J. Tuberc. Lung Dis. · Feb 2010
Timing of relapse in short-course chemotherapy trials for tuberculosis.
We have reviewed the results from 15 tuberculosis treatment trials initiated by the British Medical Research Council between 1970 and 1983 in Africa and East Asia. Of 574 relapses, 447 (78%) occurred within 6 months of stopping treatment and 525 (91%) within 12 months. We suggest that investigators should consider terminating follow-up after the last enrolled patient completes 6 months following treatment, while continuing to follow patients enrolled earlier until that time. Compared to following all patients to 24 months, the total trial duration could be reduced by 18 months, with no increase in patient numbers in a non-inferiority design.
-
Int. J. Tuberc. Lung Dis. · Feb 2010
First- and second-line drug resistance patterns among previously treated tuberculosis patients in India.
Culture and drug susceptibility testing results of 2816 tuberculosis (TB) patients from across India who had failed repeated treatments from 2001 to 2004 were retrospectively analysed at the Tuberculosis Research Centre, Chennai. Of 1498 (53%) identified as having multidrug-resistant TB (MDR-TB), 671 (44.8%) were resistant to > or =1 second-line drugs (SLDs): 490 (32.7%) to ethionamide, 245 (16.4%) to ofloxacin and 169 (11.3%) to kanamycin; 69 (4.6%) were extensively drug-resistant TB (XDR-TB). ⋯ The prevention of MDR/XDR-TB through quality DOTS services, however, remains the priority. In addition, rapid scale-up of quality programmatic management under the RNTCP is needed, with more control and rational use of SLDs outside the programme.