Improvements in treatment success rates with directly observed therapy in Rio de Janeiro City

Elizabeth C.C. Soares, A. G.F. Pacheco, F. C.Q. Mello, B. Durovni, R. E. Chaisson, S. C. Cavalcante

Research output: Contribution to journalArticle

Abstract

SETTING: Rio de Janeiro City, Brazil. OBJECTIVE: To evaluate the effect of directly observed therapy (DOT) on treatment success, by comparing the treatment success rates between patients treated under DOT with those who received self-administered therapy (SAT). DESIGN: A longitudinal study in a cohort of tuberculosis (TB) patients. Of 9929 new pulmonary TB cases, 1190 (12%) were treated under DOT and 8739 (88%) under SAT. All patients received a three-drug regimen consisting of rifampicin (RMP), isoniazid (INH) and pyrazinamide for 2 months followed by 4 months of RMP and INH. RESULTS: Patients under DOT were more likely to convert to sputum-negative at the end of the second month than those treated under SAT (86.3% vs. 61.9%, P < 0.001). DOT alone was significantly associated with successful treatment (OR 1.6, 95% CI 1.37-1.86, P < 0.001), even when controlled by sex, age and positive smear or culture at enrollment (OR 1.56, 95% CI 1.33-1.82, P < 0.001). CONCLUSION: This pilot DOTS implementation phase showed that DOT is highly effective and feasible in a large urban centre of a developing country.

Original languageEnglish (US)
Pages (from-to)690-695
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume10
Issue number6
StatePublished - Jun 1 2006

Keywords

  • DOT
  • DOTS
  • Pulmonary tuberculosis
  • Supervised treatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Soares, E. C. C., Pacheco, A. G. F., Mello, F. C. Q., Durovni, B., Chaisson, R. E., & Cavalcante, S. C. (2006). Improvements in treatment success rates with directly observed therapy in Rio de Janeiro City. International Journal of Tuberculosis and Lung Disease, 10(6), 690-695.