Comparison of the effectiveness of WHO short-course chemotherapy and standard Russian antituberculous regimens in Tomsk, western Siberia
Background There has been a resurgence of tuberculosis in Russia in the past decade. Traditional Russian services for treatment of tuberculosis are very different from those in the west. We aimed to compare the effects of WHO short-course chemotherapy with standard Russian antituberculous regimens....
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| Veröffentlicht in: | The Lancet (British edition) 2001-08, Vol.358 (9280), p.445-449 |
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| creator | Mawer, C Ignatenko, NV Wares, DF Strelis, AK Golubchikova, VT Yanova, GV Lyagoshina, TV Sharaburova, OE Banatvala, N |
| description | Background There has been a resurgence of tuberculosis in Russia in the past decade. Traditional Russian services for treatment of tuberculosis are very different from those in the west. We aimed to compare the effects of WHO short-course chemotherapy with standard Russian antituberculous regimens.
New tuberculosis patients aged 18 years or older were included in a trial and systematically allocated to traditional Russian tuberculosis treatments or WHO shortcourse chemotherapy in the two largest tuberculosis diagnostic and treatment centres of Tomsk Oblast, western Siberia. Standard WHO tuberculosis outcomes and rates of sputum conversion were used as primary outcomes. Analyses were by intention-to-treat.
646 new cases were enrolled into the trial, of which 356 patients were given Russian tuberculosis treatment (155 smear positive) and 290 were given WHO short-course chemotherapy (155 smear positive). There was no statistical difference between the proportion cured or completing treatment (63% for both groups [difference in proportion=0%, 95% CI −11 to 11%]); or dying (short-course chemotherapy, 8%vs Russian, 11% [difference in proportion=−3%, 95% CI -9 to 4%]). There was no statistical difference with respect to sputum conversion rate at 6 months (91%vs 85% [difference in proportion=6%, 95% CI -2 to 13%]). Overall, outcomes were worse among patients with multidrug resistant isolates than non-resistant isolates.
WHO short-course chemotherapy treatment for tuberculosis can work well in Russia. |
| doi_str_mv | 10.1016/S0140-6736(01)05621-5 |
| format | Article |
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New tuberculosis patients aged 18 years or older were included in a trial and systematically allocated to traditional Russian tuberculosis treatments or WHO shortcourse chemotherapy in the two largest tuberculosis diagnostic and treatment centres of Tomsk Oblast, western Siberia. Standard WHO tuberculosis outcomes and rates of sputum conversion were used as primary outcomes. Analyses were by intention-to-treat.
646 new cases were enrolled into the trial, of which 356 patients were given Russian tuberculosis treatment (155 smear positive) and 290 were given WHO short-course chemotherapy (155 smear positive). There was no statistical difference between the proportion cured or completing treatment (63% for both groups [difference in proportion=0%, 95% CI −11 to 11%]); or dying (short-course chemotherapy, 8%vs Russian, 11% [difference in proportion=−3%, 95% CI -9 to 4%]). There was no statistical difference with respect to sputum conversion rate at 6 months (91%vs 85% [difference in proportion=6%, 95% CI -2 to 13%]). Overall, outcomes were worse among patients with multidrug resistant isolates than non-resistant isolates.
WHO short-course chemotherapy treatment for tuberculosis can work well in Russia.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(01)05621-5</identifier><identifier>PMID: 11513907</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Antibiotics ; Antitubercular Agents - administration & dosage ; Antitubercular Agents - therapeutic use ; Bias ; Chemotherapy ; Clinical trials ; Collaboration ; Conversion ; Diagnostic systems ; Drug Administration Schedule ; Drug Therapy, Combination ; Female ; Humans ; Male ; Medical research ; Microscopy ; Motivation ; Multidrug resistance ; Patients ; Physicians ; Population ; Risk Factors ; Russia - epidemiology ; Siberia - epidemiology ; Smear ; Sputum ; Sputum - microbiology ; Statistics ; Substance abuse treatment ; Time Factors ; Tuberculosis ; Tuberculosis, Multidrug-Resistant - drug therapy ; Tuberculosis, Multidrug-Resistant - epidemiology ; Tuberculosis, Pulmonary - drug therapy ; Tuberculosis, Pulmonary - epidemiology ; World Health Organization</subject><ispartof>The Lancet (British edition), 2001-08, Vol.358 (9280), p.445-449</ispartof><rights>2001 Elsevier Ltd</rights><rights>Copyright Lancet Ltd. Aug 11, 2001</rights><rights>Copyright Elsevier Limited Aug 11, 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-b7b0fe4ad7c4b54926f7c579dc59059b736cd97ce6afa1ce496a2e6915ecc9bf3</citedby><cites>FETCH-LOGICAL-c416t-b7b0fe4ad7c4b54926f7c579dc59059b736cd97ce6afa1ce496a2e6915ecc9bf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673601056215$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11513907$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mawer, C</creatorcontrib><creatorcontrib>Ignatenko, NV</creatorcontrib><creatorcontrib>Wares, DF</creatorcontrib><creatorcontrib>Strelis, AK</creatorcontrib><creatorcontrib>Golubchikova, VT</creatorcontrib><creatorcontrib>Yanova, GV</creatorcontrib><creatorcontrib>Lyagoshina, TV</creatorcontrib><creatorcontrib>Sharaburova, OE</creatorcontrib><creatorcontrib>Banatvala, N</creatorcontrib><title>Comparison of the effectiveness of WHO short-course chemotherapy and standard Russian antituberculous regimens in Tomsk, western Siberia</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Background There has been a resurgence of tuberculosis in Russia in the past decade. Traditional Russian services for treatment of tuberculosis are very different from those in the west. We aimed to compare the effects of WHO short-course chemotherapy with standard Russian antituberculous regimens.
New tuberculosis patients aged 18 years or older were included in a trial and systematically allocated to traditional Russian tuberculosis treatments or WHO shortcourse chemotherapy in the two largest tuberculosis diagnostic and treatment centres of Tomsk Oblast, western Siberia. Standard WHO tuberculosis outcomes and rates of sputum conversion were used as primary outcomes. Analyses were by intention-to-treat.
646 new cases were enrolled into the trial, of which 356 patients were given Russian tuberculosis treatment (155 smear positive) and 290 were given WHO short-course chemotherapy (155 smear positive). There was no statistical difference between the proportion cured or completing treatment (63% for both groups [difference in proportion=0%, 95% CI −11 to 11%]); or dying (short-course chemotherapy, 8%vs Russian, 11% [difference in proportion=−3%, 95% CI -9 to 4%]). There was no statistical difference with respect to sputum conversion rate at 6 months (91%vs 85% [difference in proportion=6%, 95% CI -2 to 13%]). Overall, outcomes were worse among patients with multidrug resistant isolates than non-resistant isolates.
WHO short-course chemotherapy treatment for tuberculosis can work well in Russia.</description><subject>Adult</subject><subject>Antibiotics</subject><subject>Antitubercular Agents - administration & dosage</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Bias</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Collaboration</subject><subject>Conversion</subject><subject>Diagnostic systems</subject><subject>Drug Administration Schedule</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Microscopy</subject><subject>Motivation</subject><subject>Multidrug resistance</subject><subject>Patients</subject><subject>Physicians</subject><subject>Population</subject><subject>Risk Factors</subject><subject>Russia - epidemiology</subject><subject>Siberia - epidemiology</subject><subject>Smear</subject><subject>Sputum</subject><subject>Sputum - microbiology</subject><subject>Statistics</subject><subject>Substance abuse treatment</subject><subject>Time Factors</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><subject>Tuberculosis, Multidrug-Resistant - epidemiology</subject><subject>Tuberculosis, Pulmonary - drug therapy</subject><subject>Tuberculosis, Pulmonary - epidemiology</subject><subject>World Health Organization</subject><issn>0140-6736</issn><issn>1474-547X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkd9qFDEUh4Modlt9BCUoFAVHc2byp7kSWdQKhYKt6F3IZE7c1J1kTWYqfQMf22x3URDEmwQO3zn5nXyEPAL2EhjIVxcMOGuk6uQzBs-ZkC004g5ZAFe8EVx9uUsWv5EDcljKFWOMSybukwMAAZ1makF-LtO4sTmUFGnydFohRe_RTeEaI5ayLX4-PadllfLUuDTngtStcEwVzXZzQ20caJnqafNAP86lBBtrcQrT3GN28zrNhWb8GkaMhYZIL9NYvr2gP7BMmCO9CBUL9gG55-264MP9fUQ-vXt7uTxtzs7ff1i-OWscBzk1veqZR24H5XgvuG6lV04oPTihmdB9XdYNWjmU1ltwyLW0LUoNAp3Tve-OyPFu7ian73PNYMZQHK7XNmJNahQA8FZCBZ_-BV7V7WPNZlomleL6RLaVevIvCvSJ5p3QXYXEDnI5lZLRm00Oo803BpjZ2jS3Ns1WlWFgbm0aUfse74fP_YjDn669vgq83gFYf-w6YDbFBYwOh5CrQzOk8J8nfgFCCrEv</recordid><startdate>20010811</startdate><enddate>20010811</enddate><creator>Mawer, C</creator><creator>Ignatenko, NV</creator><creator>Wares, DF</creator><creator>Strelis, AK</creator><creator>Golubchikova, VT</creator><creator>Yanova, GV</creator><creator>Lyagoshina, TV</creator><creator>Sharaburova, OE</creator><creator>Banatvala, N</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TT</scope><scope>0TZ</scope><scope>0U~</scope><scope>3V.</scope><scope>7QL</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KB~</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20010811</creationdate><title>Comparison of the effectiveness of WHO short-course chemotherapy and standard Russian antituberculous regimens in Tomsk, western Siberia</title><author>Mawer, C ; Ignatenko, NV ; Wares, DF ; Strelis, AK ; Golubchikova, VT ; Yanova, GV ; Lyagoshina, TV ; Sharaburova, OE ; Banatvala, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-b7b0fe4ad7c4b54926f7c579dc59059b736cd97ce6afa1ce496a2e6915ecc9bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Antibiotics</topic><topic>Antitubercular Agents - administration & dosage</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Bias</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Collaboration</topic><topic>Conversion</topic><topic>Diagnostic systems</topic><topic>Drug Administration Schedule</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical research</topic><topic>Microscopy</topic><topic>Motivation</topic><topic>Multidrug resistance</topic><topic>Patients</topic><topic>Physicians</topic><topic>Population</topic><topic>Risk Factors</topic><topic>Russia - epidemiology</topic><topic>Siberia - epidemiology</topic><topic>Smear</topic><topic>Sputum</topic><topic>Sputum - microbiology</topic><topic>Statistics</topic><topic>Substance abuse treatment</topic><topic>Time Factors</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Multidrug-Resistant - drug therapy</topic><topic>Tuberculosis, Multidrug-Resistant - epidemiology</topic><topic>Tuberculosis, Pulmonary - 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Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mawer, C</au><au>Ignatenko, NV</au><au>Wares, DF</au><au>Strelis, AK</au><au>Golubchikova, VT</au><au>Yanova, GV</au><au>Lyagoshina, TV</au><au>Sharaburova, OE</au><au>Banatvala, N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the effectiveness of WHO short-course chemotherapy and standard Russian antituberculous regimens in Tomsk, western Siberia</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2001-08-11</date><risdate>2001</risdate><volume>358</volume><issue>9280</issue><spage>445</spage><epage>449</epage><pages>445-449</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Background There has been a resurgence of tuberculosis in Russia in the past decade. Traditional Russian services for treatment of tuberculosis are very different from those in the west. We aimed to compare the effects of WHO short-course chemotherapy with standard Russian antituberculous regimens.
New tuberculosis patients aged 18 years or older were included in a trial and systematically allocated to traditional Russian tuberculosis treatments or WHO shortcourse chemotherapy in the two largest tuberculosis diagnostic and treatment centres of Tomsk Oblast, western Siberia. Standard WHO tuberculosis outcomes and rates of sputum conversion were used as primary outcomes. Analyses were by intention-to-treat.
646 new cases were enrolled into the trial, of which 356 patients were given Russian tuberculosis treatment (155 smear positive) and 290 were given WHO short-course chemotherapy (155 smear positive). There was no statistical difference between the proportion cured or completing treatment (63% for both groups [difference in proportion=0%, 95% CI −11 to 11%]); or dying (short-course chemotherapy, 8%vs Russian, 11% [difference in proportion=−3%, 95% CI -9 to 4%]). There was no statistical difference with respect to sputum conversion rate at 6 months (91%vs 85% [difference in proportion=6%, 95% CI -2 to 13%]). Overall, outcomes were worse among patients with multidrug resistant isolates than non-resistant isolates.
WHO short-course chemotherapy treatment for tuberculosis can work well in Russia.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>11513907</pmid><doi>10.1016/S0140-6736(01)05621-5</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Antibiotics Antitubercular Agents - administration & dosage Antitubercular Agents - therapeutic use Bias Chemotherapy Clinical trials Collaboration Conversion Diagnostic systems Drug Administration Schedule Drug Therapy, Combination Female Humans Male Medical research Microscopy Motivation Multidrug resistance Patients Physicians Population Risk Factors Russia - epidemiology Siberia - epidemiology Smear Sputum Sputum - microbiology Statistics Substance abuse treatment Time Factors Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Tuberculosis, Pulmonary - drug therapy Tuberculosis, Pulmonary - epidemiology World Health Organization |
| title | Comparison of the effectiveness of WHO short-course chemotherapy and standard Russian antituberculous regimens in Tomsk, western Siberia |
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