Efficacy of the Revised National XXXX Programme.

@entity1 @entity3110 @entity5585 @entity8299 @entity1906 @entity1215 @entity378
In India, the standard regimen (SR) for treating @entity378 consisted of a 2-month intensive treatment by 2-3 inexpensive drugs followed by a 10-month course using 2 drugs. In the 1980s, this course was shortened to 6 months owing to the powerful drugs @entity1215 and @entity5585 . @entity8299 was also replaced by the more expensive but less toxic @entity3110 . The result was a short-course chemotherapy (SCC) employing 4 drugs for 2 months, followed by 2-3 drugs for 4 months of follow-up. The SCC is being pilot-tested as the Revised National @entity378 Program (RNTP); this RNTP strategy is being implemented in Delhi, Bombay, and Mehsana with the assistance of the Swedish international agency. The World Bank also endorsed RNTP, as SCC regimens under it were cost-effective. The SR and SCC regimens were also compared for Malawi, Mozambique, and Tanzania, and relatively minor differences were found in lives saved for expenditures. The claim that the rates of default under SR and SCC remain unchanged over time and the cure rates of the regimens must be challenged. The estimated cure rates of 60% for SR and 85% for SCC do not correspond to the reality in India, where 41% of @entity1 completed treatment under SR versus 47% under SCC. The cost of treatment under SR does not have to be a 5-drug regimen; re-treatment can be a 3-drug regimen, whereby the cost would be lower than assumed. The Ministry of Health and Family Welfare (MHF) was probing 253 district SCCs even in 1992-93 and accepted SCC because the World Health Organization recommended a vastly improved administration for implementation and there was a felt need from @entity1 for speedy cure. If the SCC is administered properly, it may increase the cure rate, even if cost-ineffective; if poorly managed, increased drug resistance of @entity1906 bacteria could result, which may be the present situation.
