A previous report from the Tuberculosis Chemotherapy Centre, Madras, has shown
that, if standard chemotherapy is given for one year, the response of patients treated at
home in very poor environmental circumstances is nearly as good as that of those treated
in sanatorium under much more favourable conditions. This paper reports on a four-year
follow-up of all the patients whose disease was bacteriologically quiescent at the end of the
year’s treatment. During this period, all the patients were managed on a domiciliary basis :
about a quarter of them received chemotherapy with isoniazid alone for two years, another
quarter received the drug for one year and the rest received no specific chemotherapy. Despite
adverse environmental factors (poor diet ; long hours of work often involving strenuous
physical activity ; overcrowded living conditions ; and, for the sanatorium patients, the
stresses of returning suddenly to the unfavourable home environment), the great majority
of patients in both series maintained quiescent disease throughout the follow-up period.
Furthermore, the few patients whose disease relapsed bacteriologically were at no special
dietary disadvantage in comparison with those who maintained quiescent disease throughout,
nor did they show any appreciable differences in occupation, physical activity or living
accommodation. These findings, together with the earlier ones, indicate that, despite
adverse environmental circumstances, standard chemotherapy for an adequate period
of time is sufficient in the great majority of patients for the attainment of bacteriological
quiescence and its maintenance thereafter