Supervised intermittent chemotherapy for pulmonary tuberculosis in a rural area of China

In order to ensure regularity of ambulatory treatment of new cases of pulmonary tuberculosis, a fully supervised intermittent chemotherapy regimen was tried in two rural counties of Beijing. The bare-foot doctors of the village health co-operatives were designated to administer and supervise treatment. The regimen consisted of isoniazid and streptomycin daily for 1 month, then every 3 days for 5 months and then every 5 days for a total of 12 or 18 months. For smear-negative cases the daily phase was omitted. The compliance rate among 229 patients in 1 year was 99.4%. The sputum conversion rate among 104 cases harbouring sensitive bacilli was 95.2%. Discontinuation of the regimen due to side-effects as necessary in 3 cases (1.3%). Since 1979, this treatment programme has been adopted in the whole rural area of Beijing, and the coverage rate among newly diagnosed smear-positive cases in 1983 reached 90%. A reserve regimen consisting of rifampicin and ethambutol for patients who do not convert their sputum after 6 months of treatment with isoniazid and streptomycin was added. The overall conversion rate achieved in 1981 was 97.8%. The average overall cost of drugs for each patient treated in this treatment programme was 49 yuan (RMB), about $24.00 U.S.