Intermittent supervised treatment of tuberculosis at Green Lane Hospital, 1987-8.

AIMS

to assess the results of the first two years experience with intermittent supervised treatment of tuberculosis (IST) in Auckland, looking especially at practical problems.

METHOD

the hospital records of the 16 patients who received IST during 1987-8 were reviewed retrospectively, and public health nurses who administered the medications were questioned about problems that were encountered.

RESULTS

two-thirds of those who were given IST were Polynesian. In retrospect, the need for IST could have been anticipated in eight of the 12 patients (67%) who failed to comply with daily treatment. Five of the 16 IST patients presented major problems to the nurses supervising the twice weekly treatment. Poor motivation, itinerancy and alcohol abuse were the most common factors causing difficulty. IST was successfully completed in 13/16 patients (81%) and was abandoned in only one patient. Only two patients completed IST with a drug regimen for resistant organisms. Health nurse supervision resulted in improvements in understanding and attitude to tuberculosis, eventually enabling two patients to self medicate without supervision.

CONCLUSIONS

IST is a practical treatment method in New Zealand, permitting curative therapy in a group of tuberculosis patients who would otherwise create risks of drug resistance, disease reactivation and spreading the disease.