A novel approach to directly observed therapy for tuberculosis in an HIV-endemic area |
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| Authors: | Desvarieux M Hyppolite P R Johnson W D Pape J W |
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| Affiliation: | Division of Epidemiology, School of Public Health, Department of Medicine, School of Medicine, University of Minnesota, Minneapolis, USA. desvarieux@epi.umn.edu |
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| Abstract: | OBJECTIVES: This study evaluated a novel approach to the delivery of directly observed therapy (DOT) for tuberculosis in Haiti. METHODS: A total of 194 patients (152 HIV seropositive, 42 HIV seronegative) received daily unsupervised triple-drug therapy for 4 to 8 weeks, followed by twice-weekly 2-drug therapy for the remainder of the 6-month period. DOT was deferred until initiation of the twice-weekly phase. RESULTS: A total of 169 of 194 patients (87.1%) completed the 6-month course. The program of deferred DOT had an effectiveness of 85%. Overall cost was reduced by approximately 40%. CONCLUSIONS: Flexible approaches to DOT, integrating behavioral knowledge, cost considerations, and practicality may improve completion rates and program effectiveness. |
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