Offering Choice To Tuberculosis Patients Improves Treatment Outcomes

Tuberculosis (TB) is an important disease. More than a third of the world's population has been infected with the disease. Given the right conditions, these infections can progress from latent to active disease. Even in Europe, TB is increasing in several countries. If latent TB infection is treated effectively, then many individuals can be prevented from developing TB and passing it on to their friends and families before they realise they are ill. This study, undertaken by Timothy Rennie (NE London TB Network, Homerton University Hospital, London, UK) and his colleagues, shows that giving the choice of treatment for latent infection (either a three- or a six-month course) improves adherence to therapy. More patients taking the three-month course completed treatment (60%) than those taking the six-month course (46%). Patients generally preferred the shorter three-month course. Child patients were more likely to complete treatment and patients who missed clinics before starting treatment were less likely to complete therapy. Just under one in 18 patients had the therapy stopped because of side effects, but there was no difference in side effects between the different courses of treatment. TB still needs long courses of antibiotics compared with other bacterial infections. Simple measures, such as offering choice, can be very effective. Safe, short regimens are likely to be preferred by patients and greater efforts should be made to identify these
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