When discovered, anti-tuberculosis drugs were always administered in Daily-doses; it worked wonders! Later, studies claimed these drugs could cure even in thrice-weekly doses （intermittently）. Not everyone believed ...When discovered, anti-tuberculosis drugs were always administered in Daily-doses; it worked wonders! Later, studies claimed these drugs could cure even in thrice-weekly doses （intermittently）. Not everyone believed that. Three Reviews （Cochrane, Thorax, Azhar） appear unconvinced! Also, most nations （including 20 High TB Burden Countries） continue to practice time-tested Daily dosing! INDIA adopted a unique low-cost, thrice-weekly regimen around 2000. During 15 years, under national program, Thrice-weekly doses have been administered to 15 million TB patients, self-claiming 85% success. To revisit long-term outcome of all registered patients in a district; identify the one, who didn＇t achieve long-lasting recovery with a single course, was later found re-registered for a second innings; his name figures twice in national registry （a Repeater）. Author heads District Tuberculosis Center, Faridabad, India; monitors thousands of current/ex-patients on Thrice-weekly regimen. By providence, he enjoys unique access to registered patients, data, district TB-workers. Two methods of data collection： 1. Author motivated district work-force; jointly conducted systematic Retrospective Record Review of hand-written registers of past 15 years, one at a time--thus identified over 1,575 Repeaters. 2. Author has been conducting ongoing Clinical Audit in his busy TB OPD for 6 years. He is able to cherry-pick （average） one Repeater per day; thus tracked 3,100 Repeaters-about half come in from Delhi＇s premier TB institutes, duly diagnosed, referred in for local registration for Re-treatment. Long-term fate of 36,785 registered TB patients could be analyzed. 4,675 patients observed to have returned sick, meriting Re-registration, Re-treatment; thus over 12.7 % registered twice/thrice （names, unique govt. ID＇s, irrefutable evidence enclosed）-an adverse outcome, unreported thus far-a bubble. Besides, study recorded 1,590 （5%） Deaths; 2,590 （8%） Defaulters. Under India＇s routine program conditions, Thrice-weekly regimen is ineffective. Too many （12.7%） patients come back sick, which may promote drug-resistance on industrial scale! A global threat!展开更多
文摘When discovered, anti-tuberculosis drugs were always administered in Daily-doses; it worked wonders! Later, studies claimed these drugs could cure even in thrice-weekly doses （intermittently）. Not everyone believed that. Three Reviews （Cochrane, Thorax, Azhar） appear unconvinced! Also, most nations （including 20 High TB Burden Countries） continue to practice time-tested Daily dosing! INDIA adopted a unique low-cost, thrice-weekly regimen around 2000. During 15 years, under national program, Thrice-weekly doses have been administered to 15 million TB patients, self-claiming 85% success. To revisit long-term outcome of all registered patients in a district; identify the one, who didn＇t achieve long-lasting recovery with a single course, was later found re-registered for a second innings; his name figures twice in national registry （a Repeater）. Author heads District Tuberculosis Center, Faridabad, India; monitors thousands of current/ex-patients on Thrice-weekly regimen. By providence, he enjoys unique access to registered patients, data, district TB-workers. Two methods of data collection： 1. Author motivated district work-force; jointly conducted systematic Retrospective Record Review of hand-written registers of past 15 years, one at a time--thus identified over 1,575 Repeaters. 2. Author has been conducting ongoing Clinical Audit in his busy TB OPD for 6 years. He is able to cherry-pick （average） one Repeater per day; thus tracked 3,100 Repeaters-about half come in from Delhi＇s premier TB institutes, duly diagnosed, referred in for local registration for Re-treatment. Long-term fate of 36,785 registered TB patients could be analyzed. 4,675 patients observed to have returned sick, meriting Re-registration, Re-treatment; thus over 12.7 % registered twice/thrice （names, unique govt. ID＇s, irrefutable evidence enclosed）-an adverse outcome, unreported thus far-a bubble. Besides, study recorded 1,590 （5%） Deaths; 2,590 （8%） Defaulters. Under India＇s routine program conditions, Thrice-weekly regimen is ineffective. Too many （12.7%） patients come back sick, which may promote drug-resistance on industrial scale! A global threat!
