[Curative treatment of tuberculosis in the world]

Recent WHO recommendations for the treatment of tuberculosis have emphasized the need for simplicity and standardization of short term chemotherapy regims which can be applied in all forms of tuberculosis, including both pulmonary and extrapulmonary forms. But in order for the recommended chemotherapy regimes to be effective, there is a need for precise organization. Patient care must begin with the first consultation, dosage must be adapted to patient weight, drug intake must, at least during the initial phase of treatment, be supervised and patients who are absent or irregular should be recalled, surveillance and correction of rare side effects should be recorded, global consideration of the patient's medical and social problems and laboratory (and clinical) check-ups at the end of the initial phase of treatment and again at the end of treatment. Together, the aim of these technical and organizational measures is the limit the development bacterial resistance both to isoniazid and to rifampicin. In countries with limited financial resources, where the majority of the tuberculosis population lives, a reliable network of laboratories equipped with microscopes and a permanent anti-tuberculosis supply organization are required for any and all treatment programmes. In all countries, the evaluation of results using representative cohorts and surveillance of bacterial resistance provide evidence that such policies are successful.