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Increasing directly observed therapy related to improved tuberculosis treatment outcomes in Taiwan.

AbstractSETTING:
Directly observed therapy (DOT) is a core element of tuberculosis (TB) care and control efforts. In Taiwan, DOT was implemented in 2006, when the Stop TB Strategy was adopted as a national policy.
OBJECTIVE:
To quantify DOT among patients on anti-tuberculosis treatment and measure the association between proportion of DOT and TB treatment outcomes at a national level in Taiwan.
DESIGN:
We analyzed data prospectively collected on all new pulmonary TB cases reported to the national web-based registry between 1 January 2007 and 30 June 2008. We compared treatment outcomes and proportion of DOT in multivariable analyses.
RESULTS:
Among 11,528 patients initiating anti-tuberculosis treatment, the proportion of days during which an official DOT observer witnessed treatment was >60% for 5150 (45%) patients and ≤60% for 4601 (40%) patients, whereas for 1777 (15%) patients no days of DOT were recorded. Being older, male, having positive bacteriology results and a non-World Health Organization recommended treatment regimen at baseline were independently related to unsuccessful treatment outcomes and mortality. A dose-response effect was found between proportion of DOT and these outcomes.
CONCLUSION:
These findings highlight the importance of ensuring universal DOT in improving treatment outcomes among new pulmonary TB patients.
AuthorsE Bloss, P-C Chan, N-W Cheng, K-F Wang, S-L Yang, P Cegielski
JournalThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 16 Issue 4 Pg. 462-7 (Apr 2012) ISSN: 1815-7920 [Electronic] France
PMID22640512 (Publication Type: Journal Article)
Chemical References
  • Antitubercular Agents
Topics
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents (administration & dosage, therapeutic use)
  • Child
  • Child, Preschool
  • Directly Observed Therapy (methods)
  • Dose-Response Relationship, Drug
  • Female
  • Health Policy
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Registries
  • Risk Factors
  • Sex Factors
  • Taiwan
  • Treatment Outcome
  • Tuberculosis, Pulmonary (drug therapy)
  • Young Adult

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