Literature DB >> 12921147

Decentralisation of directly observed treatment in a large African city: evaluation of the experience of Djibouti.

J J Bernatas1, I M Ali, H A Ismaël, A B Matan, I H Aboubakar.   

Abstract

SETTING: Decentralisation of directly observed treatment (DOT) for tuberculosis patients in three public centres in Djibouti city from April 2000.
OBJECTIVES: To evaluate decentralisation based on the success rate by site of treatment and according to certain critical variables.
METHODS: Comparative evaluation of the success rate of smear-positive patients followed in all treatment centres from 1 May 2000 to 31 March 2001.
RESULTS: The success rate was 58% for the main centre, Centre Paul Faure, and 81% for all the peripheral centres together (P < 10.6). It was 80% for the three new centres and 85% for the established centres (P > 0.05). Age under 20 years, female sex and treatment centre were factors linked to success. After stratification, sex was shown to be the confounding variable. Multivariate analysis shows that non-Djibouti nationality is related to treatment success (P = 0.02). In the groups of established and new centres, there is an inverse linear relationship between success rate and workload, with greater capacity in the established centres.
CONCLUSIONS: Urban decentralisation of DOT increases the chances of treatment success among smear-positive patients. Another centre for supervised treatment needs to be created in one of the public health centres in Djibouti city.

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Year:  2003        PMID: 12921147

Source DB:  PubMed          Journal:  Int J Tuberc Lung Dis        ISSN: 1027-3719            Impact factor:   2.373


  2 in total

Review 1.  Decentralization of health systems in low and middle income countries: a systematic review.

Authors:  Daniel Cobos Muñoz; Paloma Merino Amador; Laura Monzon Llamas; David Martinez Hernandez; Juana Maria Santos Sancho
Journal:  Int J Public Health       Date:  2016-08-29       Impact factor: 3.380

2.  Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in Gansu Province, China.

Authors:  Xiaolin Wei; Guanyang Zou; Hui Zhang; Renzhong Li; John D Walley; Shiwen Jiang; Jia Yin; Shuigao Jin; You Li; Qiang Sun; James N Newell; Sian Griffiths; Lixia Wang
Journal:  BMC Public Health       Date:  2011-02-15       Impact factor: 3.295

  2 in total

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