High cure rates in smear-positive tuberculosis patients using ambulatory treatment with once-weekly supervision during the intensive phase in Sulawesi, Republic of Indonesia.

Setting: The four provinces of Sulawesi, Republic of Indonesia.

Objective: Treatment of smear-positive pulmonary tuberculosis patients using ambulatory treatment with supervision once weekly during the intensive phase and once fortnightly during the continuation phase.

Design: Pilot projects with gradual expansion of activities according to defined quantitative criteria.

Results: During the period January 1993-December 1997, 11,879 new smear-positive and 320 smear-positive previously treated patients, of whom 259 were relapses, were placed on short-course chemotherapy. At the end of the intensive phase, 87.5% of new patients and 80.0% of retreatment patients had become sputum smear-negative. During the period January 1993-December 1996, of 7,251 new smear-positive patients placed on treatment 85.2% were cured and an additional 7.9% had completed treatment, giving a total success rate of 93.1%. For 239 patients placed on retreatment the total success rate was 86.6%.

Conclusion: The treatment results show that the policy introduced in Sulawesi is effective. In two provinces priority will now be given to increasing case detection, while in the other two provinces the emphasis will be on reaching full coverage. The reasons for the success of the projects are discussed, as are the prerequisites for introducing the policy in other areas.