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Int J Tuberc Lung Dis. 1999 Dec;3(12):1061-5.

Direct observation of tuberculosis treatment by supervised family members in Yasothorn Province, Thailand.

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  • 1Seventh Region Communicable Disease Control, Ubonratchathani, Thailand.

Abstract

SETTING:

Yasothorn Province, Thailand.

OBJECTIVE:

To evaluate the effectiveness of a programme offering the option of direct observation of treatment (DOT) by a supervised family member.

METHODS:

Review of patient records and district registers in Yasothorn Province after implementation of the revised tuberculosis control strategy.

RESULTS:

From 1 October 1996 to 30 September 1997, the programme registered 779 patients: 366 smear-positive pulmonary, 357 smear-negative pulmonary, and 56 extra-pulmonary. DOT was given in 243 (66%) smear-positive, 83 (23%) smear-negative, and in 21 (38%) extra-pulmonary cases; the observer was a family member in 299 (86.2%) of the 347 cases. By December 1998, treatment outcomes were determined for the 695 new patients (326 smear-positive, 321 smear-negative, 48 extra-pulmonary) of the 779 registered during the period under study. In new smear-positive patients, cure rates were 184/216 (85.2%, 95% confidence interval [CI] 80.5-89.9) with DOT versus 78/110 (70.9%, 95% CI 62.4-79.4) with self-administration.

CONCLUSION:

The overall cure rate was 80.4% in a programme in which trained and supervised family members directly observed the treatment of two-thirds of sputum smear-positive patients. Supervised family members may contribute to more widespread effective implementation of the revised tuberculosis strategy in Thailand.

PMID:
10599008
[PubMed - indexed for MEDLINE]
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