Faisabilité de la stratégie de lutte par moustiquaires de lit imprégnées d'insecticide rémanent en zone rurale au Cameroun

Les auteurs ont évalué la faisabilité en zone rurale de la stratégie de lutte par moustiquaires de lit imprégnées d'insecticide rémanent. L'intérêt en est bien perçu par les populations, en terme de protection contre les nuisances et non de prévention de la maladie. Son utilisation par contre laisse beaucoup à désirer et demande d'étudier un matériel adaptable à la variabilité des modalités de couchage, et d'intensifier les efforts de formation/information auprès des utilisateurs potentiels. (Résumé d'auteur

High effectiveness of a 12-month regimen for MDR-TB patients in Cameroon

SETTING Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon. OBJECTIVE To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients. DESIGN Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation. RESULTS Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m(2) and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients. CONCLUSIONS These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance

Outcome of tuberculosis retreatment in routine conditions in Cotonou, Benin.

SETTING: National Tuberculosis Programme (NTP), Cotonou, Benin. OBJECTIVE: To study the patient characteristics and outcome of tuberculosis retreatment cases in a well-functioning NTP. METHODS: A retrospective, register-based study of all smear-positive pulmonary tuberculosis cases put on retreatment (2SERHZ/1ERHZ/5R3H3E3) between 1992 and 2001 in Cotonou. For comparison, information on new smear-positive cases in Cotonou in 1999 was entered and analysed. RESULTS: Of 8103 tuberculosis patients registered, 642 were put on retreatment. The analysis is mainly based on the 236 patients whose initial treatment regimen records were available (113 relapses, 84 failures, 39 returns after default). Most of the relapse (57%) and return after default (72%) cases were put on retreatment within 12 months after stopping their initial treatment. Overall, the retreatment results were satisfactory (78% success) and comparable with those of new cases (82%); the failure rates were low (3%), as were those for initial treatment (1%). There were more defaulters from retreatment among those who had already defaulted from initial treatment (21%). Treatment success rates were better among women than men. CONCLUSION: The standardised retreatment regimen is effective in Cotonou, probably because the NTP is functioning well, there are no drug shortages, drug taking is strictly supervised, and a good treatment plan is followed

Faisabilité de la stratégie de lutte par moustiquaires de lit imprégnées d'insecticide rémanent en zone rurale au Cameroun

Les auteurs ont évalué la faisabilité en zone rurale de la stratégie de lutte par moustiquaires de lit imprégnées d'insecticide rémanent. L'intérêt en est bien perçu par les populations, en terme de protection contre les nuisances et non de prévention de la maladie. Son utilisation par contre laisse beaucoup à désirer et demande d'étudier un matériel adaptable à la variabilité des modalités de couchage, et d'intensifier les efforts de formation/information auprès des utilisateurs potentiels. (Résumé d'auteur