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Twice weekly vs. daily chemotherapy for childhood tuberculosis

dc.contributor.authorTe Water Naude J.M.
dc.contributor.authorDonald P.R.
dc.contributor.authorHussey G.D.
dc.contributor.authorKibel M.A.
dc.contributor.authorLouw A.
dc.contributor.authorPerkins D.R.
dc.contributor.authorSchaaf H.S.
dc.date.accessioned2011-05-15T16:17:38Z
dc.date.available2011-05-15T16:17:38Z
dc.date.issued2000
dc.identifier.citationPediatric Infectious Disease Journal
dc.identifier.citation19
dc.identifier.citation5
dc.identifier.issn08913668
dc.identifier.urihttp://hdl.handle.net/10019.1/14305
dc.description.abstractBackground. Treating childhood tuberculosis places a large burden on health services, and ways of lessening this were sought. Methods. A randomized controlled trial was conducted to determine the effectiveness of fully intermittent twice weekly treatment for intrathoracic childhood tuberculosis and its effect on adherence to treatment, in comparison with daily (weekday) treatment. The setting was a district of Cape Town, South Africa, an area of high incident tuberculosis. We randomized 206 children with confirmed (4%), probable (94%) and suspected (2%) intrathoracic tuberculosis: 89 (median age, 25 months) received intermittent treatment; and 117 (median age, 28 months) received daily treatment. Intermittent treatment (twice weekly for 6 months) was isoniazid 15 mg/kg/dose, rifampin 15 mg/kg/dose and pyrazinamide 55 mg/kg/dose for 2 months, followed by isoniazid and rifampin only for 4 months. Daily treatment was isoniazid 10 mg/kg/day, rifampin 10 mg/kg/day and pyrazinamide 25 mg/kg/day on weekdays for 6 months. Results. At 6 months 97% of subjects were discharged, with treatment outcomes in the two groups equivalent at that time (P = 0.90) and at the 18- to 30- month follow-up. One relapse occurred in the twice weekly group (P = 0.25). Adherence was equivalent; 70 children (79%) on intermittent and 90 (77%) on daily treatment took 75% or more of the prescribed doses (P = 0.90). Nonadherence over the full course of therapy was significantly associated with nonadherence during the first month of treatment (P = 0.0002) and household crowding (P = 0.002). Conclusions. Six month fully intermittent antituberculosis treatment is an effective and acceptable alternative to daily treatment.
dc.subjectisoniazid
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjectarticle
dc.subjectchild
dc.subjectclinical trial
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectdrug efficacy
dc.subjecthuman
dc.subjectlung tuberculosis
dc.subjectmajor clinical study
dc.subjectpatient compliance
dc.subjectpriority journal
dc.subjectrandomized controlled trial
dc.subjectrelapse
dc.subjecttreatment outcome
dc.subjectAntitubercular Agents
dc.subjectChild, Preschool
dc.subjectDrug Administration Schedule
dc.subjectFemale
dc.subjectHumans
dc.subjectInfant
dc.subjectIsoniazid
dc.subjectMale
dc.subjectPatient Compliance
dc.subjectPyrazinamide
dc.subjectRifampin
dc.subjectSouth Africa
dc.subjectTreatment Outcome
dc.subjectTuberculosis, Pulmonary
dc.titleTwice weekly vs. daily chemotherapy for childhood tuberculosis
dc.typeArticle
dc.description.versionArticle


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