Adverse drug reactions of Intermittent chemotherapy compared to daily regimen in Sudanese patients with pulmonary Tuberculosis

The World Health Organization [WHO] declared Tuberculosis a global health emergency in 1993 as it remains a major cause of mortality in developing countries. The World Health Organization's Directly Observed Treatment Short course [DOTs] strategy achieve 87% success rate in the areas where it is implemented, usually with five drugs, lasts for 6months. Till 1998 Sudan was classified as one of the slowly moving countries in implementation of the DOTS strategy and making no progress against tuberculosis. A prospective comparative, randomized clinical trial, hospital based study carried out at Kosti Teaching Hospital using directly observed treatment short course [DOTS], to assess the adverse drug reactions of intermittent chemotherapy compared to the currently adopted short course therapy. Patients with smear positive new cases of tuberculosis were enrolled and randomized in to two groups, intermittent treatment group [A] and daily regimen group [B] .The raw data were introduced into SPSS program, the data comparison was carried out by Pearson Chi square and pair independent sample student T-test. The level of significance [P<0.05]. A total of 275 were studied, significant initial [pre-interventional] elevated means of aspartate aminotransferase [AST] was detected in the two groups and significantly in the intermittent regimen after two and four months, but the decrease was significant only after two months in the daily group. Liver injury following antituberculous treatment was minimal and the adverse drug reactions were tolerable concerning the majority of the patients completing the course of the treatment

Improving rational drug use in Africa: the example of Sudan

The aim of this review is to determine the extent of irrational drug use and contributing factors in Sudan and to identify the interventions that need to be strengthened to promote the rational use of drugs in the country and to evaluate the impact of different types of intervention. We present an overview of studies describing patterns of drug prescribing, dispensing and self-medication. Rates for inappropriate prescribing and dispensing practices and prevalence of self-medication with antimicrobials and herbal products were alarmingly high. Indicators of rational drug use have worsened over the past decade despite the implementation of managerial, regulatory and training interventions. Multifaceted interventions have proved effective in changing suboptimal prescribing practices. Educational interventions are needed to address self-medication and adherence