A successful supervised outpatient short-course tuberculosis treatment program in an open refugee camp on the Thai-Cambodian border

The operation of a tuberculosis treatment program in an open refugee camp of 45,000 refugees on the Thai-Cambodian border is described. Fifty-eight patients received 6 months of supervised daily outpatient therapy with a protocol employing isoniazid, rifampin, streptomycin, and pyrazinamide. Patient compliance was high, with only 15 of 10,209 patient days being missed, despite a high incidence of minor side effects. Three patients died, 4 defaulted, and 1 moved to another camp for treatment. The therapies of 4 patients were extended because of the need for reduced doses of medications, the development of extrapulmonary disease, treatment failure, and slow resolution of infiltrates on radiographs. There was 1 late relapse. This report demonstrates the feasibility of integrating short-course therapies with program designs to produce high compliance under difficult field conditions.