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A novel approach to directly observed therapy for tuberculosis in an HIV-endemic area

2001; American Public Health Association; Volume: 91; Issue: 1 Linguagem: Inglês

10.2105/ajph.91.1.138

1541-0048

Moı̈se Desvarieux, P.R. HYPPOLITE, William D. Johnson, Jean W. Pape,

Pneumocystis jirovecii pneumonia detection and treatment

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.