K Tsuchida1, H Koyanagi. 1. Naka Health Centre of Yokohama City, Nihon-odori, Naka-ku, Yokohama City, Japan. ke00-tsuchida@city.yokohama.jp
Abstract
BACKGROUND: Yokohama City is currently developing directly observed treatment (DOT) in its programme, and requires guidance on types of DOT appropriate for local conditions. OBJECTIVE: To assess the effectiveness of DOT for tuberculosis treatment in a retrospective study under operational conditions in Yokohama City. METHODS: We included 80 patients with sputum-positive tuberculosis, 39 enrolled in DOT and 41 self-administered patients. The study was done at the National Hospital for Chest Diseases and the Community Clinic, which provide tuberculosis services with a standard daily short-course regimen. The main outcome measures were cure and treatment completion. RESULTS: The cure or treatment completion rate for the DOT and self-administered groups were respectively 87.2% and 68.3%. In a multivariate logistic regression model, cure or treatment completion was significantly associated with out-patient DOT (OR 4.04, 95%CI 1.22-13.33, P = 0.022). CONCLUSION: DOT was shown to be significantly superior to the self-administered regimen. However, our results were from an impoverished population with city-sponsored apartments and supplementary benefits. Further research will be needed to know the effectiveness of DOT in the general population.
BACKGROUND: Yokohama City is currently developing directly observed treatment (DOT) in its programme, and requires guidance on types of DOT appropriate for local conditions. OBJECTIVE: To assess the effectiveness of DOT for tuberculosis treatment in a retrospective study under operational conditions in Yokohama City. METHODS: We included 80 patients with sputum-positive tuberculosis, 39 enrolled in DOT and 41 self-administered patients. The study was done at the National Hospital for Chest Diseases and the Community Clinic, which provide tuberculosis services with a standard daily short-course regimen. The main outcome measures were cure and treatment completion. RESULTS: The cure or treatment completion rate for the DOT and self-administered groups were respectively 87.2% and 68.3%. In a multivariate logistic regression model, cure or treatment completion was significantly associated with out-patient DOT (OR 4.04, 95%CI 1.22-13.33, P = 0.022). CONCLUSION: DOT was shown to be significantly superior to the self-administered regimen. However, our results were from an impoverished population with city-sponsored apartments and supplementary benefits. Further research will be needed to know the effectiveness of DOT in the general population.