Duration of treatment and other aspects of tuberculosis control

Contains fulltext : 19113_duraoftra.pdf (publisher's version ) (Open Access)Inclusion criteria were study populations of patients with predominantly pulmonary tuberculosis, cervical tuberculous lymphadenitis, tuberculous meningitis, spinal tuberculosis and tuberculosis of the kidney and urinary tract. The diagnosis had been confirmed bacteriologically and/or histologically, or was made probably by using clinical and laboratory markers. Treatment management had to include at least isoniazid, rifampicin and pyrazinamide and a follow-up of at least 12 months after the end of treatment. Exclusion criteria: Patients with resistance and previous treatment of tuberculosis. Outcome measure: The number of patients who relapsed after treatment was calculated. Conclusion: After a 6 month treatment, tuberculosis relapse occurred in 116/4833 (2.4%; 95% C.I. 2.0-2.8) of the patients with pulmonary tuberculosis, 13/422 (3.3%; 95% C.I.1.7-5.5) of the patients with cervical lymph node tuberculosis, 2/131 (1.5%; 95% C.I. 0.2-5.5) of the patients with meningitis tuberculosis, 0/56 (0%; 95% C.I.v0.0-6.4) of the patients with bone tuberculosis and 1/170 (0.6%; 95% C.I. 0.0-3.2) of the patients with kidney tuberculosis. Irrespective of the main diagnosis, no patient group with a 6 months treatment regimen had lower treatment results than the patient group with treatment regimens of longer than 6 months duration. DNA fingerprinting techniques can be used to determine whether a patient is reinfected with the same or with different tubercle bacteria. The close correlation between the use of pyrazinamide measured by means of the Dutch Drug Information Project and the Netherlands Tuberculosis Register is described. This provides strong evidence that in the Netherlands tuberculosis is reported in conformity with the guidelines for notifiable diseases. The method was simply to apply and may deserve following-up in other countries183 p