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The Medication Monitor for Treating Tuberculosis in the Developing Countries


 Significant advances to reduce the problem of poor patient compliance with antituberculosis drug regimens have been the development of intermittent or short-term regimens where some member of the health team directly administers or supervises each dose of medication. Such supervised regimens for all patients is a missapplication of technology. The least expensive, reasonably effective drug regimen for many developing countries is isoniazid and thiacetazone for 18 months with an initial 2-month supplement of streptomycin, yet many failures occur primarily because of poor patient compliance. A medication monitor is the best means for differentiating reliable from unreliable patients, allowing the appropriate degree of supervision to be selected for each patient. A model illustrating the principle of the medication monitor is shown in figure form. Trials with this type of device in both developed and developing countries have demonstrated that it can differentiate reliable from unreliable patients. 1 problem previously inhibiting the use of the medication monitor is the lack of a means for immediate development of the filmstrip if developing tanks and darkrooms are not readily available. The film has been packaged in a water-tight envelope of opaque polyvinyl chloride, and this prevents the film from being exposed to light and also functions as a developing tank. The lowering of cost and the creation of a simple film development system makes the medication monitor an attractice alternative to completely supervised short-term or intermittent chemotherapy for reliable and reasonably reliable patients.
