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Am J Public Health. 1996 Aug;86(8):1094-7.

Directly observed therapy for tuberculosis in rural South Africa, 1991 through 1994.

Author information

1
Centre for Epidemiological Research, South African Medical Research Council, Hlabisa, South Africa.

Abstract

OBJECTIVES:

This paper describes an audit of a community-based tuberculosis treatment program involving directly observed therapy in South Africa.

METHODS:

A program audit of 2473 consecutive tuberculosis patients in Hlabisa Health District, KwaZulu/Natal, South Africa, was conducted between 1991 and 1994.

RESULTS:

Monthly admissions increased from 34 per month in 1991 to 66 in 1994. Of 2186 patients managed in Hlabisa, 1903 (87%) received directly observed therapy. Of those receiving directly observed therapy, 1034 (55%) were supervised by volunteers; 743 (72%) of these were supervised by storekeepers. Among those patients managed locally, 1679 (85%) of 1967 surviving patients completed treatment. Completion rates for patients supervised by health workers and non-health workers were the same. Completion fell from a high of 90% in 1992 to 78% in 1994. Mortality increased from 5% in 1991 to 10% in 1994.

CONCLUSIONS:

Community-based directly observed therapy that uses an intermittent drug regime and volunteers as supervisors can achieve high treatment completion rates for tuberculosis, even in resource-poor settings.

PMID:
8712267
PMCID:
PMC1380619
DOI:
10.2105/ajph.86.8_pt_1.1094
[Indexed for MEDLINE]
Free PMC Article

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