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037-PA12 Kampo medicine in tuberculosis treatment
Abstracts
continued evolvement and development of strategies for its containment and control. Recognition of the importance and resurgence of TB in the 1990's must be addressed from many diverse angles, always focusing on the community that is being targeted. Sydney, New South Wales, Australia has a hugely diverse socio-economic, cultural and literacy mix. Thus any campaign to heighten awareness and educate on any disease will require careful planning and thought. These include: •
EDUCATION:
•
INCREASING COMMUNITY AWARENESS: IDENTIFYING THE INFECTED POOL:
•
• • •
DATA SURVEILLANCE: PROMOTION OF TB SERVICES: IMPROVED LIAISON WITH ALLIED SERVICES:
Education Modules, Pamphlets
Health Promotion
Surveys and target group screening TB relevant data base Access to services
Community based services
This talk will outline the strategies for the implementation of a TB awareness campaign in a challengingly diverse society.
037-PA12 treatment
Kampo medicine in tuberculosis
Kos, S., Hougkov& J. Lung Hospital Janov, MiroYov, Czech Republic
Kampo medicine is a traditional Japanese therapeutic method using natural products, mostly extracts of herbs. Therapeutic study with the aim to investigate the hepatoprotective and supportive effects of the Kampo drug TJ-9/Sho-saiko-to (product of Tsumura and Co., Tokyo) was performed. Two parallel groups of 20 patients with bacteriologically proven and previously untreated lung tuberculosis were hospitalized and treated with hepatotoxic drugs INH, RMP, PZA and EMB or STM for 2-3 months. One group, indicated A, obtained in addition thrice daily 2.5 g of TJ-9, while the control group B had no additional Kampo treatment. The average age in the A group was remarkably lower (41 vs. 61.4 years), the extent and bacteriological relevance of the disease was more grave also in the group A. In spite of that the mean debacillization time in the T J-9 treated group was only 1.2 weeks longer than in the control group. TJ-9 was well tolerated and the TJ-9 co-treated group proved statistically more rapid decline of raised erythrocyte sedimentation rate and lower level of glutamyltransferase.
105
050-PAl2 Tuberculosis control in Kenya - 25 years' experience at Ngaira Chest Clinic, Nairobi Thuku, R. W. City Council of Nairobi, Kenya
In Kenya diagnosis of tuberculosis (TB) in the early days was based merely on suspicion after having symptoms such as persistent cough of a long duration, drastic weight loss and haemoptysis. Treatment included improved nutrition, rest, isolation, ventilation and the use of traditional medicines. In the late fifties the National Tuberculosis Programme was started and a new era in the diagnosis and treatment of TB commenced. Between 1958 and 1973 the National Tuberculosis Programme registered a downward trend in the case detection rate which levelled off through 1984. Since then a sharp increase has been observed. This has been attributed to the Human Immunodeficiency Virus infection. In this paper, a twenty-five year experience in the diagnosis, treatment and management of patients attending the Ngaira Avenue Chest Clinic in Nairobi, Kenya, will be presented.
059-PA12 Knowledge, attitudes and practices in tuberculosis of health care workers in Cali, Colombia Jaramillo, E. Colombian League Against Tuberculosis, Cali, Colombia
Tuberculosis (TB) is a leading cause of death in developing countries. Most of TB National Control Programs, unfortunately, have not achieved the proposed goals. Nurses are the most important link between patients and the Program. A qualitative research was carried out in 1992, aimed to raise hypothesis about the role of health care workers in the TB control Program. Techniques used consisted of direct observation, indepth and informal interviews, and focus groups with patients and all the nurses and nurse-assistants involved in TB control activities. All observations were uncovered. Inquiry ended when new supplementary information was not observed or obtained. Lack of basic knowledge related with T B control was common. It was found a widespread fear of getting infected from the patient. Nurses were interested in providing educative information to patients but messages usually were wrong: 'don't work until the end of treatment', 'avoid direct contact with children', 'don't kiss and share foods or cutlery with anybody', 'avoid sex', etc. Patients used to be blamed for treatment uncompliance and disordered behavior with rules of health dispensary. Social isolation was selected as the main consequence for anybody with TB, followed by lost of ability to work. The patient was considered an unlucky person that inspired compassion and fear. Nurses' and nurse-assistants' knowledge of TB control is inadequate to cope with the Program objectives. Their attitudes toward TB patients were ambivalent, and their behavior promoted isolation and strengthened the
continued evolvement and development of strategies for its containment and control. Recognition of the importance and resurgence of TB in the 1990's must be addressed from many diverse angles, always focusing on the community that is being targeted. Sydney, New South Wales, Australia has a hugely diverse socio-economic, cultural and literacy mix. Thus any campaign to heighten awareness and educate on any disease will require careful planning and thought. These include: •
EDUCATION:
•
INCREASING COMMUNITY AWARENESS: IDENTIFYING THE INFECTED POOL:
•
• • •
DATA SURVEILLANCE: PROMOTION OF TB SERVICES: IMPROVED LIAISON WITH ALLIED SERVICES:
Education Modules, Pamphlets
Health Promotion
Surveys and target group screening TB relevant data base Access to services
Community based services
This talk will outline the strategies for the implementation of a TB awareness campaign in a challengingly diverse society.
037-PA12 treatment
Kampo medicine in tuberculosis
Kos, S., Hougkov& J. Lung Hospital Janov, MiroYov, Czech Republic
Kampo medicine is a traditional Japanese therapeutic method using natural products, mostly extracts of herbs. Therapeutic study with the aim to investigate the hepatoprotective and supportive effects of the Kampo drug TJ-9/Sho-saiko-to (product of Tsumura and Co., Tokyo) was performed. Two parallel groups of 20 patients with bacteriologically proven and previously untreated lung tuberculosis were hospitalized and treated with hepatotoxic drugs INH, RMP, PZA and EMB or STM for 2-3 months. One group, indicated A, obtained in addition thrice daily 2.5 g of TJ-9, while the control group B had no additional Kampo treatment. The average age in the A group was remarkably lower (41 vs. 61.4 years), the extent and bacteriological relevance of the disease was more grave also in the group A. In spite of that the mean debacillization time in the T J-9 treated group was only 1.2 weeks longer than in the control group. TJ-9 was well tolerated and the TJ-9 co-treated group proved statistically more rapid decline of raised erythrocyte sedimentation rate and lower level of glutamyltransferase.
105
050-PAl2 Tuberculosis control in Kenya - 25 years' experience at Ngaira Chest Clinic, Nairobi Thuku, R. W. City Council of Nairobi, Kenya
In Kenya diagnosis of tuberculosis (TB) in the early days was based merely on suspicion after having symptoms such as persistent cough of a long duration, drastic weight loss and haemoptysis. Treatment included improved nutrition, rest, isolation, ventilation and the use of traditional medicines. In the late fifties the National Tuberculosis Programme was started and a new era in the diagnosis and treatment of TB commenced. Between 1958 and 1973 the National Tuberculosis Programme registered a downward trend in the case detection rate which levelled off through 1984. Since then a sharp increase has been observed. This has been attributed to the Human Immunodeficiency Virus infection. In this paper, a twenty-five year experience in the diagnosis, treatment and management of patients attending the Ngaira Avenue Chest Clinic in Nairobi, Kenya, will be presented.
059-PA12 Knowledge, attitudes and practices in tuberculosis of health care workers in Cali, Colombia Jaramillo, E. Colombian League Against Tuberculosis, Cali, Colombia
Tuberculosis (TB) is a leading cause of death in developing countries. Most of TB National Control Programs, unfortunately, have not achieved the proposed goals. Nurses are the most important link between patients and the Program. A qualitative research was carried out in 1992, aimed to raise hypothesis about the role of health care workers in the TB control Program. Techniques used consisted of direct observation, indepth and informal interviews, and focus groups with patients and all the nurses and nurse-assistants involved in TB control activities. All observations were uncovered. Inquiry ended when new supplementary information was not observed or obtained. Lack of basic knowledge related with T B control was common. It was found a widespread fear of getting infected from the patient. Nurses were interested in providing educative information to patients but messages usually were wrong: 'don't work until the end of treatment', 'avoid direct contact with children', 'don't kiss and share foods or cutlery with anybody', 'avoid sex', etc. Patients used to be blamed for treatment uncompliance and disordered behavior with rules of health dispensary. Social isolation was selected as the main consequence for anybody with TB, followed by lost of ability to work. The patient was considered an unlucky person that inspired compassion and fear. Nurses' and nurse-assistants' knowledge of TB control is inadequate to cope with the Program objectives. Their attitudes toward TB patients were ambivalent, and their behavior promoted isolation and strengthened the