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  • Title: Feasibility study of a district tuberculosis control programme with an 8-month short-course chemotherapy regimen utilizing the integrated health service network under field conditions in Nepal.
    Author: Onozaki I, Shakya TM.
    Journal: Tuber Lung Dis; 1995 Feb; 76(1):65-71. PubMed ID: 7718850.
    Abstract:
    SETTING: Tuberculosis in Nepal has not been controlled; there is an annual risk of infection of more than 2%, a cure rate of 30-40% and a casefinding rate of 40%. The necessity of a pilot programme with short-course chemotherapy that could be applied across the nation was discussed, and an operational research project utilizing the existing basic health service network was launched. OBJECTIVE: The main objective was to assess the feasibility of integrating a tuberculosis programme into the basic health services under various field conditions, and of introducing an 8-month short-course chemotherapy regimen instead of the 12-month standard regimen. DESIGN: A tuberculosis control programme package based on the current international strategy was introduced in Dhading and Chitawan districts (population 650,000) in 1990. The reported results were confirmed by central supervision and a follow-up study. RESULTS: 454 new smear-positive cases were found in the first year. 69% were cured and 9% completed their treatment. However an 85% completion rate could be expected from the results of the follow-up study. CONCLUSION: An integrated tuberculosis control programme with short-course chemotherapy is feasible. An adequate supply of drugs and supervision are vital components. The results showed the possibility of achieving the international target of an 85% cure rate and 70% detection, even within the constraints of the field conditions in Nepal.
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