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Tuberculosis treatment in complex emergencies: are risks outweighing benefits? | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Tuberculosis treatment in complex emergencies: are risks outweighing benefits?

Biot M, Chandramohan D, Porter JDH
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Abstract
Tuberculosis (TB) is a major public health problem in complex emergencies. Humanitarian agencies usually postpone the decision to offer TB treatment and opportunities to treat TB patients are often missed. This paper looks at the problem of tuberculosis treatment in these emergencies and questions whether treatment guidelines could be more flexible than international recommendations. A mathematical model is used to calculate the risks and benefits of different treatment scenarios with increasing default rates. Model outcomes are compared to a situation without treatment. An economic analysis further discusses the findings in a trade-off between the extra costs of treating relapses and failures and the savings in future treatment costs. In complex emergencies, if a TB programme could offer 4-month treatment for 75% of its patients, it could still be considered beneficial in terms of public health. In addition, the proportion of patients following at least 4 months of treatment can be used as an indicator to help evaluate the public health harm and benefit of the TB programme.

Subject Area

tuberculosis

Languages

English
Published Date
10 Mar 2003
PubMed ID
12631310
Journal
Tropical Medicine and International Health
Volume | Issue | Pages
Volume 8, Issue 3, Pages 211-8