S K Tripathy1, P Kumar1, K D Sagili2, D A Enarson3. 1. National Tuberculosis Institute, Bangalore, India. 2. International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India. 3. The Union, Paris, France.
Abstract
SETTING: The Revised National Tuberculosis Control Programme in an urban setting of Bangalore City, India. OBJECTIVES: To compare treatment outcomes and smear conversion rates among new smear-positive tuberculosis (TB) patients undergoing treatment administered by community directly observed treatment (DOT) providers with those undergoing treatment administered by institutional DOT providers in Bangalore City in 2010-2011. METHOD: Cohort study of routine data recorded from treatment cards of TB patients undergoing treatment under the public health services from 1 October 2010 to 30 September 2011. RESULT: Treatment records of 1864 new smear-positive TB patients registered during this period were evaluated. Among those evaluated, 604 (32%) had been administered treatment by community DOT providers and the remainder by institutional DOT providers. The treatment success rate in those undergoing community DOT was 93% (n = 564) and that of those undergoing institutional DOT was 75% (n = 951; RR 1.23, 95%CI 1.19-1.28). The sputum smear conversion rate of patients who underwent community DOT was 92% and that of those who underwent institutional DOT was 71% at the end of 2 months. CONCLUSION: We conclude that community DOT for treatment supervision of TB patients is more effective than institutional DOT and that it should be reinforced.
SETTING: The Revised National Tuberculosis Control Programme in an urban setting of Bangalore City, India. OBJECTIVES: To compare treatment outcomes and smear conversion rates among new smear-positive tuberculosis (TB) patients undergoing treatment administered by community directly observed treatment (DOT) providers with those undergoing treatment administered by institutional DOT providers in Bangalore City in 2010-2011. METHOD: Cohort study of routine data recorded from treatment cards of TB patients undergoing treatment under the public health services from 1 October 2010 to 30 September 2011. RESULT: Treatment records of 1864 new smear-positive TB patients registered during this period were evaluated. Among those evaluated, 604 (32%) had been administered treatment by community DOT providers and the remainder by institutional DOT providers. The treatment success rate in those undergoing community DOT was 93% (n = 564) and that of those undergoing institutional DOT was 75% (n = 951; RR 1.23, 95%CI 1.19-1.28). The sputum smear conversion rate of patients who underwent community DOT was 92% and that of those who underwent institutional DOT was 71% at the end of 2 months. CONCLUSION: We conclude that community DOT for treatment supervision of TB patients is more effective than institutional DOT and that it should be reinforced.
Entities:
Keywords:
DOT providers; DOTS; community volunteers
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