The management and control of tuberculosis in Malta

Abstract

Tuberculosis is a chronic disease caused by Mycobacterium tuberculosis. The disease occurs throughout the world and remains an important cause of morbidity and mortality in many developing countries. Each year, it is estimated that 8 million new cases occur and that it causes three million deaths. Whereas its prevalence has declined considerably in the industrial world within the last 50 years, it has re-emerged among patients with human immunodeficiency virus. The use of chemotherapy have contributed generously to the rapid decline in tuberculosis mortality occurring in the last four decades. The use of chemotherapy in non-compliant patients has been successful to a much lesser extent. Fixed dose combination products have been formulated to minimise the compliance required for the patient to adhere to the treatment regimen. The quality control and bioavailability of fixed dose combination preparations has recently been disputed. Three studies were performed in order to: Study A i) analyse the local behaviour of tuberculosis since it became a notifiable disease by legislation in 1908, and ii) study the impact of chemotherapy on the epidemiology of tuberculosis in Malta. Study B Assess the compliance with prescribed treatment regimens among tuberculosis patients. Study C Perform and compare the in vitro dissolution profile of a locally manufactured generic preparation of Rifampicin 300mg and Isoniazid 150rog tablets to that of Rimactazid 300 tablets, and to compare the rates of release of rifampicin from these formulation with the release of rifampicin from Rimactane 300 capsules.