Best dissertation section

Abstract

Tuberculosis is the cause of a large burden of disease in less developed countries. With the development of drug resistance and the co-epidemic of HIV, tuberculosis has already started to make a comeback in wealthier countries. The WHO's solution to this global tuberculosis epidemic is the DOTS strategy, the implementation of which presents many problems. The two issues most common to the majority of locations are delay in presentation for treatment and non-completion of treatment. This review looks at the reasons for these problems in the less developed world, and addresses some solutions. The main reasons for delayed presentation are: a lack of understanding about TB; the stigma associated with the disease; the inaccessibility of treatment; and a preference for private practitioners. The main reasons for non-completion of treatment are: the stigma of the disease; a lack of information; dissatisfaction with the treatment and its delivery; and inaccessibility of treatment. Successful implementations of the DOTS strategy need to address all these issues. There is little evidence that DOT enhances treatment completion unless combined with other strategies. Community-based, patient-orientated DOTS appears to be an appropriate way of addressing many of these issues. The involvement of volunteers in community-based strategies is common, but needs more research in order for this strategy to realise its full potential.

Formulation and Pharmacokinetics of Self-Assembled Rifampicin Nanoparticle Systems for Pulmonary Delivery

“…Treatment of tuberculosis is an arduous and lengthy process requiring combination antibiotic therapy administered daily for at least six months (4). During this extended therapy, patients may terminate treatment early due to factors such as unwanted side effects or alleviation of primary symptoms (5). Partial treatment of TB can make the disease more difficult to treat since selection of drug-resistant mutants of M. tuberculosis may occur.…”

Factors associated with patient and health care system delay in diagnosis for tuberculosis in the province of Luanda, Angola

“…Factors contributing to delay in diagnosis and treatment are likely to vary depending on the populations in their local settings. Several reviews have analysed factors associated with patient and system delay [14-16]. Thomas (2002) addressed a descriptive analysis of factors related to delay.…”

Pharmaceutical aerosols for the treatment and prevention of Tuberculosis

“…The extended use of these antibiotics frequently produces unwanted side effects in patients due to intrinsic drug toxicity. During this extended therapy, patients may terminate treatment early due to many factors like unwanted side effects or alleviation of primary symptoms (Thomas, 2002). Partial treatment can make the disease more difficult to treat since selection of drug resistant mutants of M. tuberculosis may occur (Garcia-Contreras et al, 2010).…”