|INTERMITTENT TREATMENT WITH STREPTOMYCIN AND INH
IN RURAL AREA
|V Govindaswamy & D Savic: Proceed Natl TB &
Chest Dis Workers Conf, Ahmedabad, 1965, 113-28.
There is a wide spread prejudice among the staff
of health centres that patients invariably prefer injection and
it was felt by many health workers that streptomycin containing
intermittent regimens would be more acceptable to rural patients.
A study was carried out to find out the acceptability and applicability
of an intermittent supervised drug regimen containing streptomycin
1 gm and INH 650 mgm once a week in a rural area as well as the
regularity with which the rural folk took this treatment. Association
between the observed regularity and factors like age, sex etc.,
was also analysed. 107 rural patients of tuberculosis, diagnosed
at 5 taluk hospitals in Ananthapur district of Andhra Pradesh on
the basis of sputum examination by direct smear and/or X-ray examination
with the help of mobile X-rays, consented to treatment with intermittent
regimen mentioned above. About half of them were new patients and
the rest were old patients who were mostly regular on an earlier
oral regimen. 94 of the above were available for analysis.
The regimen was found quite practicable in the
sense that at no centre the study was interrupted or discontinued
because of the inability of the health centre staff to give injection.
If regularity is expressed as a proportion of patients who at any
given time had taken the optimal amount of treatment (no. of injections),
then 40 patients (42%) were found regular on the intermittent regimen,
36 patients were classified as lost and the remaining had 3 or less
injections due and had not yet had the chance to become lost according
to the definition adopted. Thus, the regularity of those accepting
the regimen was quite low. There was very steep fall in regularity
during the first 10 weeks of treatment, nearly a half of the total
cases became irregular during the first 6 weeks. Beyond 4 months
of treatment, patients who continued to attend centres regularly
for treatment became negligible, thus pointing that injection was
not a key variable in the treatment regularity of tuberculosis.
|KEY WORDS: CASE HOLDING, PHIs, SUPERVISED INTERMITTENT
REGIMEN, TREATMENT, CONTROL PROGRAMME.