 |
The 130th Annual Meeting of APHA |
|
The 130th Annual Meeting of APHA |
Peter Zyambo, Mr, Public Health Department, Kitwe City Council & District Health Board, P.o Box 20555, Kitwe, Zambia, 260 96 785135, peterzyambo@yahoo.com
BACKGROUND: Studies indicate 60-70 % of TB-HIV co-infection. Recurrent cases have increased up-to 30%;most people getting 2-3 TB episodes before death . An operational study was carried out in Kitwe- Zambia: To compare the outcomes of Cat II, a more intensive and expensive regime to Cat III, a less intensive, safer and cheaper treatment, and link with HIV positive individuals. METHODS: Out of 230 patients with Recurrent TB in 1995-1996; 62 were enrolled after a consent to VCT. 10(16%) were undergoing Re-treatment regime (cat II) and 53(84%) the Test regimen (cat III); all under DOTS. RESULTS: HIV prevalence in cohorts was 7/10(70%) cat II and 49/53(92%) cat III. Treatment outcomes(survival rates) after 8 months: 8/10(80%) Cat II and 47/53(78%) cat II. Not significantly different (Fishers' Exact Test, p>0.5); at 24 months survival rate dropped considerably to 1/10(10%) Cat II and 28/53(54%) Cat III. Significantly different (Fishers Exact Test, p=0.016); at 48+ months 1/10(10%) cat II and 16/53(16%) cat III. Not significantly different (Fishers Exact Test, p=0.263). Cat III drugs were ten-fold cheaper than cat II . CONCLUSION Sample sizes were small and influence of confounders demand adjustments. It is likely that Cat III is safer, cheaper and more effective with indications that it may be better in short term. In low income countries, cat III should be considered. Cat II be reserved for infectious cases. It is not advantageous, but 10 times costly, high risk for reactions and HIV.
Key: Cat II=2SERHZ/1ERHZ/5ERH Cat III=2RHZ/6EH or 4RH
Learning Objectives: At the conclusion of the session, the the participant will be able to
Keywords: Treatment Outcomes, Tuberculosis
Related Web page: N/A
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.