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Tuberculosis remains a major public-health problem in Bangladesh, despite national efforts to improve case identification and treatment compliance. In 1984, BRAC (formerly the Bangladesh Rural Advancement Committee), a national, non-governmental organisation, began an experimental tuberculosis-control programme in one thana (subdistrict). Community health workers screened villagers for chronic cough and collected sputum samples for acid-fast bacillus (AFB) microscopy (phase one). Positive patients received 12 months of directly observed therapy. Phase two (1992-94) included another nine thanas and, in phase three (1995), eight more thanas were included. From 1995, the treatment was an 8-month oral regimen.In 1995-96, we analysed all programme data from 1992 to 1995. First we analysed phases two (12-month therapy) and three (8-month therapy) separately for proportion cured, died, treatment, failed, defaulted, migrated, and referred. Second, we did a cross-sectional survey of tuberculosis cases in more than 9000 randomly selected households in two phase-two thanas and one non-programme thana, and analysed the follow-up of all patients treated in the programme thanas.In the phase-two analysis, 3497 (90

作者:A M, Chowdhury;S, Chowdhury;M N, Islam;A, Islam;J P, Vaughan

来源:Lancet (London, England) 1997 年 350卷 9072期

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收藏
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作者:
A M, Chowdhury;S, Chowdhury;M N, Islam;A, Islam;J P, Vaughan
来源:
Lancet (London, England) 1997 年 350卷 9072期
标签:
Asia Bangladesh Communicable Disease Control Community Workers--women Delivery Of Health Care Developing Countries Diseases Drugs Economic Factors Health Health Personnel Health Services Infections Low Income Population Nongovernmental Organizations Organization And Administration Organizations Program Effectiveness Program Evaluation Programs Social Class Socioeconomic Factors Socioeconomic Status Southern Asia Treatment Tuberculosis--prevention and control
Tuberculosis remains a major public-health problem in Bangladesh, despite national efforts to improve case identification and treatment compliance. In 1984, BRAC (formerly the Bangladesh Rural Advancement Committee), a national, non-governmental organisation, began an experimental tuberculosis-control programme in one thana (subdistrict). Community health workers screened villagers for chronic cough and collected sputum samples for acid-fast bacillus (AFB) microscopy (phase one). Positive patients received 12 months of directly observed therapy. Phase two (1992-94) included another nine thanas and, in phase three (1995), eight more thanas were included. From 1995, the treatment was an 8-month oral regimen.In 1995-96, we analysed all programme data from 1992 to 1995. First we analysed phases two (12-month therapy) and three (8-month therapy) separately for proportion cured, died, treatment, failed, defaulted, migrated, and referred. Second, we did a cross-sectional survey of tuberculosis cases in more than 9000 randomly selected households in two phase-two thanas and one non-programme thana, and analysed the follow-up of all patients treated in the programme thanas.In the phase-two analysis, 3497 (90