medigraphic.com
ISSN 0016-3813 (Print)

2004, Number 1

Next >>

Gac Med Mex 2004; 140 (1)

Effect of Shortened Directly Observed Treatment on Compliance and Cure Rate of Pulmonary Tuberculosis.

Martínez-Medina MA

Language: Spanish
References: 36
Page: 1-6
PDF size: 446.34 Kb.


ABSTRACT

Objective: To evaluate shortened directly observed treatment (DOTS) for management of pulmonary tuberculosis and to compare its outcomes with self-administered therapy (SAT). Material and Methods: Evaluation of DOTS, implemented since 1998, was compared with a cohort of pulmonary tuberculosis patients under SAT from 1992 to 1997. Efficacy and efficiency of treatment were evaluated to agree with the National Tuberculosis Control Program. The study was conducted at a primary health care center in Hermosillo, Sonora, Mexico. Results: One hundred thirty eight patients with smear-positive pulmonary tuberculosis were included, 45 in DOTS cohort and 93 in SAT. Efficiency was higher in DOTS-managed cases compared with SAT cohort (95.5% vs 76.3%), p ‹0.05. Indeed, efficiency was significantly higher in relapsed patients treated under DOTS, p ‹0.05. The non-compliance rate declined to 0.0% in the DOTS cohort. Twenty six percent of DOTS patients were supervised as outpatients. Conclusions: Implementation of DOTS was a flexible and effective strategy in treatment of pulmonary tuberculosis. DOTS allows treatment completion, decline in non-compliance, and increase in care rate.


REFERENCES

  1. Dye C, Scheele S, Dolin P, Patahania V, Raviglione M. Global burden of tuberculosis. JAMA 1999;282:677-86.

  2. Combs DL, O'Brien RJ, Geiter LJ. USPHS tuberculosis short-course chemotherapy trial 21: effectiveness, toxicity and acceptability. Ann Intern Med 1990;112:397-406.

  3. Addington W. Patient compliance: the most serious remaining problem in the control of tuberculosis in the United States. Chest 1979;76:Suppl:741-3.

  4. Daniel TM. Tuberculosis. In: Wilson JD, Braunwald E, Isselbacher KJ, Petersdorf RG, Martin J, Fauci A, Root RK, editors. Harrison. Principios de medicina interna. Vol I. Madrid, Spain: Interamericana, 1991.

  5. Globe M, Iseman MD, Madsen LA, Waite D, Ackerson L, Horsburgh CR. Treatmen of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Eng J Med 1993;328:527-32.

  6. Olle-Goig JE. Patients with tuberculosis in Bolivia: why do they died ? Rev Panam Salud Publica 2000;8:151-54.

  7. Word Health Organization. What is DOTS? A guide to undestanding the WHO-recommended TB control strategy known as DOTS. Geneva, Switzerland; World Health Organization. 1999.

  8. Wilkinson D. High compliance tuberculosis treatment programme in a rural community. Lancet 1994;343:647-48.

  9. Murray CJL, DeJonghe E, Chum HF, Nyangulu DS, Salomao A, Stylblo K. Cost effectiveness of chemoterapy for pulmonary tuberculosis in three sub-Saharan African countries. Lancet 1991;338:1305-08.

  10. Iseman MD, Cohn DL, Sbarbaro JA. DOT for tuberculosis: we can’t afford not to buy it. N Engl J Med 1993;328:576-78.

  11. Moore RD, Chaulk CP, Griffiths R, Cavalcante S, Chaisson RE. Cost effectiveness directly observed versus self-administered therapy for tuberculosis. Am J Respir Crit Care Med 1996;154:1013-19.

  12. Burman WJ, Dalton CB, Cohon DL, Butter JR, Reves RR. A costeffectiveness analysis of directly observed therapy vs self-administered therapy for treatment of tuberculosis. Chest 1997;112:63-70.

  13. World Health Organization. Comunicable Disease Programme. Global Tuberculosis Control. Geneva, Switzerland: World Health Organization; 2000. Publication WHO/CDS/TB/2000.275.

  14. Morse D. Directly observed therapy for tuberculosis. BMJ 1996;312:719-20.

  15. Sistema Nacional de Salud. Manual de normas y procedimientos para la prevención y control de la tuberculosis. México, 1992.

  16. Sector Salud. Manual de procedimientos. Programa Nacional de Prevención y Control de la Tuberculosis. México, 1996.

  17. Hollingshead AB. Two factor Index of social position. New Haven, CT, Yale University; 1958.

  18. Block AB, Simone PM, Leary LS, Hayden CH, Saggerson JJ, Castro KG. Completenes of tuberculosis (TB) therapy in the US, 1993. Am J Respir Crit Care Med 1996;153:A333.

  19. García ML, Mayar MM, Ferreyra L, Palacios MM, Alvarez GC, Valdespino GJ. Eficacia y eficiencia del tratamiento antituberculoso en jurisdicciones sanitarias de Morelos. Salud Publica Mex 1998;40:421-29.

  20. Alvarez GG, Dorantes JJ. Tratamiento acortado estrictamente supervisado para tuberculosis pulmonar. Salud Publica Mex. 1998;40:272-75.

  21. Sbarbaro JA. Public health aspects of tuberculosis: supervision of therapy. Clin Chest Med 1980;1:253-63.

  22. Ferrer X, Kirschbaum A, Toro J, Jadue J, Muñoz M, Espinoza A. Adherencia al tratamiento de la tuberculosis del adulto en Santiago, Chile. Bol of Sanit Panam 1991;111:423-31.

  23. Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ovellettev L. How often is medication taken as prescribed? A novel assessment technique. JAMA 1989;262:1472.

  24. Cohn DL, Catlin BJ, Peterson KL, Judson FN, Sbarbaro JA. A 62-dose, 6-month therapy for pulmonary and extrapulmonary tuberculosis: a twiceweekly, directly observed, and cost-effective regimen. Ann Intern Med 1990;112:407-15.

  25. Solórzano MJ, Alvarez CM. Atención del enfermo tuberculoso a nivel comunitario en el estado de Chiapas, México. Bol of Sanit Panam 1991;111:432-38.

  26. Bayer R, Wilkinson D. Directly observed therapy for tuberculosis: history of an idea. Lancet 1995;345:1545-48.

  27. Volmink J, Garner P. Directly observed therapy. Lancet 1997;349:1399-00.

  28. Zwarenstein M, Schoeman JH, Vundule C. Lombard CJ, Tatley M. Randomised controlled trial of self-supervised and directly observed treatment of tuberculosis. Lancet 1998;352:1340-43.

  29. China Tuberculosis Control Collaboration. Results of directly observed short course chemotherapy in 112,842 Chinese patients with smearpositive tuberculosis. Lancet 1996;347:358-62.

  30. Frieden TR, Fujiwara PI, Washko RM, Hamburg MA. Tuberculosis in New York City- turning the tide. N Engl J Med 1995;333:229-33.

  31. Chaulk CP, Moore-Rice K, Rizzo R, Chaisson RE. Eleven years of community–based directly observed therapy for tuberculosis. JAMA 1995;274:945-51.

  32. Zhang LX, Tu DH, Enarson DA. The impact of directly-observed treatment on the epidemiology of tuberculosis in Beijing. Int J Tuber Lung Dis 2000;4:904-10.

  33. Pablos-Mendez A, Raviglione MC, Laszlo A, Binkin N, Rieder HL, Bustreo F, et al. Global surveillance for antituberculosis-drug resistance, 1994-1997. N Engl J Med 1998;338:1641-49.

  34. Weis SE, Slocum PC, Blais FX, King B, Nunn M, Matney B, et al. The effect of directly observed therapy on the rates of drug resistance and relapse in tuberculosis. N Engl J Med 1994;330:1179-84.

  35. Chowdhury AM, Chowdhury S, Islam MN, Islam A, Vaughan JP. Control of tuberculosis by community health workers in Bangladesh. Lancet 1997;350:169-72.

  36. Volmink J, Matchaba P. Directly observed therapy and treatment adherence. Lancet 2000;355:1345-50.




2020     |     www.medigraphic.com