[procaare] DOTS effectiveness - biological factors

[RS Wallis <rsw2@po.cwru.edu>]

RE: Effectiveness of the direct observation component of DOTS for tuberculosis:
a randomised controlled trial in Pakistan (A.Shaw, ProCAARE 4/25/01)
---------------------------

These findings are very interesting. Similar negative results were reported 
by Zwarenstein in a South African study of DOTS effectiveness (Lancet 
1998;352:1340). 

We have speculated that biological factors, including mycobacterial drug 
tolerance, host pharmacokinetics, or immune function may contribute 
to the poor outcome of TB therapy in certain parts of the world 
(JID 1998;178:1115, AAC 1999;43:2600, JID 2001;183:1300). 

Further research in this area is urgently needed. 

RS Wallis, M.D. 
UMDNJ - New Jersey Medical School 
Medical Science Bldg I-503 
185 S. Orange Ave. 
Newark, NJ 07103-2714 
(973) 972-8778 (voice) 
(973) 972-8878 (fax) 
wallisrs@umdnj.edu (e-mail) 
http://tuberculosis.umdnj.edu 

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