Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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San Francisco Examiner - October 1, 2002
Angelina Malhotra-Singh Of The Examiner Staff
Patients currently require twice-weekly doses of the drugs isoniazid and rifampin, but the new routine consists of a single weekly dose of the two drugs.
Tuberculosis, once close to eradication, is again a looming national and global health threat. In San Francisco, infection rates rose nearly 7 percent from 2000 to 2001.
The treatment, already used in some places, will be available at the Department of Public Health's Tuberculosis Clinic before the end of the year, said the clinic's Dr. Masae Kawamura. About one-third of the clinic's 150 to 200 patients will be able to switch to the once-a-week schedule.
Because the majority of infected patients are refugees, intravenous drug users and homeless people -- one in seven street dwellers is a TB carrier -- caregivers believe it will be easier to keep up with once-a-week medical visits, particularly because the therapy takes at least six months.
Getting patients to continue treatment to the "medically cured" stage is vital, in part because patients tend to feel better long before they are healed.
The treatment program is likely to be instituted in jails, a particularly high-risk setting for infection as a result of close living conditions.
Because TB bacteria are airborne, the leap from inmate to inmate -- and from inmate to guard and to visitor -- is quick.
People with advanced TB cannot switch to the new treatment, nor can "double positives" -- HIV-infected TB patients. Twenty-five percent of San Francisco inmates have HIV and TB.
E-mail: asingh@sfexaminer.com
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