ABSTRACT
Five hundred (500) cases of pulmonary tuberculosis (TB) were seen at the Chest Clinic of the National Hospital; Abuja; Nigeria over a 2-year period (2004-2005). The diagnosis and management of multidrug-resistant (MDR) TB were studied as part of DOTS-Plus: Directly Observed Treatment Short-course (DOTS) programmes that add components for MDR-TB diagnosis; management; and treatment. The cases of pulmonary TB that showed mycobacterium resistance to rifampicin and isoniazid (MDR-TB) using the Lowenstein Jensen (solid medium) slope at the National Hospital and later using BACTEC 460 available at Zankli Medical Center at Abuja; were treated with the standard WHO recommended regimen for MDR-TB and the outcomes were studied. Twenty cases (4) of MDRTB were recorded; all 20 were also HIV-positive. One (8) died and 19 (95) were apparently cured at the end of therapy. This is the first report of MDR-TB and DOTS-Plus in Nigeria. There is an urgent need to study the MDR-TB pattern in Nigeria as extensive resistant TB (XDR-TB) has now been reported which is even worse prognostically than MDR-TB
Subject(s)
Directly Observed Therapy , Nigeria , Tuberculosis, Multidrug-Resistant , Tuberculosis, Pulmonary/diagnosisABSTRACT
The knowledge and practice regarding tuberculosis (TB) treatment was surveyed by analysing questionnaires distributed to 390 general and private medical practitioners in Nigeria. Of the 350 (89) questionnaires returned; 305 (87.1) practitioners had treated TB cases in their hospitals. The number of regimens recorded were 85 for newly diagnosed (ND) cases and for 45 re-treatment (RT) cases. The National Tuberculosis Control Programme (NTCP)-approved regimen were used in 61 (20) ND cases and 60 (19.7) RT cases. The number of inadequate regimens prescribed were 60 (70.6) for ND cases and 36 (80) for RT cases; 34 (40) practitioners wrongly stated that strepto- mycin should be used for ND cases. In ND cases; regimens lasting less than 6 months were prescribed in 8 (9.4) cases; and regiments lasting more than 12 months were prescribed in 10 cases (11.7). Other aspects of poor knowledge were exhibited by a significant number of respondents who estimated seeing an average of 1525 TB patients each month. It was concluded that a significant number of physicians in private practice did not adhere to the standard norms for prescribing anti-TB treatment; did not know about the regimen recommended by the NTCP; and often prescribed wrong regimens. Intervention strategies in the form of continuing medical education in TB should be urgently organised for general and private medical practitioners if the disease is to be controlled in Nigeria