CHAPTER IV - TREATMENT BEHAVIOUR OF TB PATIENTS <<Back
 
a) Treatment Failure & The Problem of Non Adherence
 
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AU : Bellin E
TI : Failure of tuberculosis control: a prescription for change.
SO : JAMA 1994, 271, 708-709.
DT : Per
AB :

This article presents some studies to depict the dramatic increase in TB incidence in the United States due to its failure to co-ordinate the medicare care provision, disease surveillance and societal will to consistently provide TB therapy and monitor TB control. The author considers that the collective apathy has led to increase in multi-drug resistance. Using incidence rates to track TB (thus failing to track the completion of therapy) and, having no systematic national reporting of completion rates are regarded as evidence of institutionalised apathy. Maintaining a prevalence registry is administratively labor-intensive, therefore, it is suggested that local health departments must enter data into computers as reports arrive rather than perform batch entry, three months later. Generating monthly reports for field workers identifying non-compliant patients or non-reporting physicians, offering non-compliant patients, DOT, education and appropriate incentives are other steps to curb TB. Having automated laboratory surveillance of antibiotic susceptibilities of mycobacterial isolates is essential to produce timely reports to enable physicians to adjust their prescribing practices, to facilitate outcome research, to suggest useful regimens for study and allow for the creation of infrastructure necessary for organising countrywide clinical therapy trials.

KEYWORDS: COMPLIANCE; DEFAULT; USA.
 
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