Management of pulmonary tuberculosis PTB: regimen employed in Lagos, Nigeria

The regimen(s) employed for the management of pulmonary tuberculosis (PTB) by health institutions in Lagos State, Nigeria was determined. Results from the 134 health institutions, showed that only 71.7% of the 120 (89.6%) health institutions with records of PTB, manage these cases. 28.3% refer diagnosed cases to referral (chest) centres. 4.7% administered multiple regimen and 93.0%, single regimen of different drug combinations for different treatment periods/durations. The study showed that 36.9% of the health institutions in Lagos employed a short course chemotherapy (SCC) treatment of between 6 to 9 months duration, while 32.2% employ the longer course of chemotherapy with duration of treatment not less than 10 months. Majority, employed the SCC regimen of 6 months duration using 2SRHZ/4RH combination. Most of the institutions employed a regimen outside the national adopted 8 months regimen that consist of four drugs: streptomycin (S), or ethambutol (E), rifampicin (R), isoniazid (H), and pyrazinamide (Z) for the first two months of intensive treatment and two drugs of isoniazid (H) and thiacetazone (T), for the final continuation phase of six months. (i.e. a regimen of 2S or ERHZ/6TH). The overall results, showed there is no commonly accepted PTB treatment regimen in Lagos and the national adopted regimen is not favoured by many health institutions. There is the need for the development of a standard, generally accepted, affordable and cost effective treatment regimen for the state and country, for effective monitoring and coordination.