Svetlana Doltu1, Ana Ciobanu2, Yuliia Sereda3, Ruth Persian4, Luke Ravenscroft4, Liana Kasyan5, Nune Truzyan5, Andrei Dadu2, Anthony Reid6. 1. NGO 'AFI', Chisinau, Republic of Moldova. svetlana.doltu@gmail.com. 2. WHO Regional Office for Europe, Copenhagen, Denmark. 3. Independent Consultant, Kyiv, Ukraine. 4. The Behavioural Insight Teams, London, United Kingdom. 5. American University of Armenia, Erevan, Republic of Armenia. 6. Médecins Sans Frontières, Brussels, Belgium.
Abstract
INTRODUCTION: The Republic of Moldova is among the 18 high priority countries for tuberculosis (TB) in Europe. This study compared adherence and short and long-term TB treatment outcomes for TB patients who experienced asynchronous Video Observed Treatment (aVOT) during three months of outpatient treatment versus Directly Observed Treatment (DOT) in operational conditions in 2016-2017 in Chisinau. METHODOLOGY: We used secondary data from the 2016-2017 Randomized Clinical Trial (RCT) that piloted the aVOT Strategy in Chisinau and data from the national TB register. Relative risk was selected as a measure of association in analysis of treatment strategies (aVOT and DOT under operational conditions) and short and long-term treatment outcomes. RESULTS: From 647 TB patients included in the study, 169 followed the treatment strategy in the RCT (83 in aVOT and 86 in DOT) and 478 were on DOT in operational conditions. Those in aVOT were more likely to have favourable short-term outcome than patients with DOT in operational conditions (RR 0.07; p < 0.001). TB recurrence as an indicator for the long-term outcome, was observed in group with DOT in operational conditions (40 cases, p = 0.006). CONCLUSIONS: This study demonstrated that the aVOT treatment strategy was associated with better adherence and both short and long-term TB treatment favourable outcomes. aVOT as a new patient-centred approach supporting TB patients on improving treatment adherence and outcomes might be recommended as an alternative to DOT strategy in the Republic of Moldova. Copyright (c) 2021 Svetlana Doltu, Ana Ciobanu, Yuliia Sereda, Ruth Persian, Luke Ravenscroft, Liana Kasyan, Nune Truzyan, Andrei Dadu, Anthony Reid.
INTRODUCTION: The Republic of Moldova is among the 18 high priority countries for tuberculosis (TB) in Europe. This study compared adherence and short and long-term TB treatment outcomes for TB patients who experienced asynchronous Video Observed Treatment (aVOT) during three months of outpatient treatment versus Directly Observed Treatment (DOT) in operational conditions in 2016-2017 in Chisinau. METHODOLOGY: We used secondary data from the 2016-2017 Randomized Clinical Trial (RCT) that piloted the aVOT Strategy in Chisinau and data from the national TB register. Relative risk was selected as a measure of association in analysis of treatment strategies (aVOT and DOT under operational conditions) and short and long-term treatment outcomes. RESULTS: From 647 TB patients included in the study, 169 followed the treatment strategy in the RCT (83 in aVOT and 86 in DOT) and 478 were on DOT in operational conditions. Those in aVOT were more likely to have favourable short-term outcome than patients with DOT in operational conditions (RR 0.07; p < 0.001). TB recurrence as an indicator for the long-term outcome, was observed in group with DOT in operational conditions (40 cases, p = 0.006). CONCLUSIONS: This study demonstrated that the aVOT treatment strategy was associated with better adherence and both short and long-term TB treatment favourable outcomes. aVOT as a new patient-centred approach supporting TB patients on improving treatment adherence and outcomes might be recommended as an alternative to DOT strategy in the Republic of Moldova. Copyright (c) 2021 Svetlana Doltu, Ana Ciobanu, Yuliia Sereda, Ruth Persian, Luke Ravenscroft, Liana Kasyan, Nune Truzyan, Andrei Dadu, Anthony Reid.
Entities:
Keywords:
SORT IT; outcomes; tuberculosis; video observed treatment