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Titolo:
Epidemiological analysis of tuberculosis treatment outcome as a tool for changing TB control policy in Israel
Autore:
Chemtob, D; Epstein, L; Slater, PE; Weiler-Ravell, D;
Indirizzi:
Minist Hlth, Dept TB & AIDS, IL-91010 Jerusalem, Israel Minist Hlth Jerusalem Israel IL-91010 & AIDS, IL-91010 Jerusalem, Israel Minist Hlth, Dept Epidemiol, IL-91010 Jerusalem, Israel Minist Hlth Jerusalem Israel IL-91010 demiol, IL-91010 Jerusalem, Israel Hadassah Med Org, Jerusalem, Israel Hadassah Med Org Jerusalem IsraelHadassah Med Org, Jerusalem, Israel Hebrew Univ Jerusalem, Sch Publ Hlth & Community Med, Jerusalem, Israel Hebrew Univ Jerusalem Jerusalem Israel Community Med, Jerusalem, Israel
Titolo Testata:
ISRAEL MEDICAL ASSOCIATION JOURNAL
fascicolo: 7, volume: 3, anno: 2001,
pagine: 479 - 483
SICI:
1565-1088(200107)3:7<479:EAOTTO>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
DIRECTLY OBSERVED THERAPY; DOTS STRATEGY; EUROPE;
Keywords:
tuberculosis epidemiology; outcome of TB treatment; treatment policy; immigration; Israel;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Chemtob, D Minist Hlth, Dept TB & AIDS, POB 1176, IL-91010 Jerusalem, Israel Minist Hlth POB 1176 Jerusalem Israel IL-91010 rusalem, Israel
Citazione:
D. Chemtob et al., "Epidemiological analysis of tuberculosis treatment outcome as a tool for changing TB control policy in Israel", ISR MED ASS, 3(7), 2001, pp. 479-483

Abstract

Background: Sensing an inadequacy of tuberculosis control due to an influxof TB associated with immigration, we analyzed TB treatment outcome in Israel by population groups,Objectives: To provide an epidemiological basis necessary for any new national TB control policy, and to bring it to the attention of the medical profession in Israel and abroad since its results led to a change in Israel's TB control policy. Methods: We reviewed all TB cases notified during the period 1990 to September 1992. "New cases" (820 cases, 93.5%) and "re-treatment cases" (57 cases, 6.5%) were analyzed according to three mutually exclusive groups:"successful outcome," "death," and "potentially unsatisfactory outcome" (accordingto WHO/IUATLD definitions). Results: Of 820 "new cases," 26.6% had a "satisfactory outcome," 68.5% hada "potentially unsatisfactory outcome" and 4.9% died; compared to 47.4%, 45.6% and 7% among 57 "re-treatment cases," respectively. Using logistic regression analysis, outcome was associated with the district health office (P<0.0001), the TB "experience" of the notifying clinic (P <0.0001), and theform of TB (P=0.02). No significant relationships were obtained for population groups, gender and age, interval between arrival in Israel and TB notification, and bacteriological results. Conclusions: Non-supervised TB treatment resulted in poor outcomes regardless of population groups. Better outcomes occurred in the larger TB clinics. Therefore, in addition to measures such as adequate drug supplies, reorganization of TB laboratories and training of TB personnel, we recommend the "directly observed treatment short-course" for all cases as well as reducing the number of treatment centers thereby increasing their case load.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 12:32:46