Directly observed therapy for tuberculosis: the Harlem Hospital experience, 1993.
OBJECTIVE
A directly observed therapy program was established at Harlem Hospital, New York, NY, in 1993 to promote high tuberculosis treatment completion rates.


METHODS
The Harlem program used an on-site surrogate family model. Treatment completion rate, visit adherence rate, human immuno-deficiency virus seroprevalence, and time to sputum culture conversion were assessed.


RESULTS
Out of 145 enrolled patients with suspected and confirmed tuberculosis, 95 (92 confirmed and 3 suspected) continued treatment. The visit adherence rate was 91.1 +/- 7.9%, with one patient (1%) lost to follow-up.


CONCLUSIONS
High rates of treatment completion and visit adherence were achieved because of unique program characteristics. Thus, directly observed therapy is advocated as a means of ensuring treatment completion.
el-Sadr
W
W
Division of Infectious Diseases, Harlem Hospital Center, New York, NY 10037, USA.
Medard
F
F
Berthaud
V
V
Barthaud
V
V
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003266:Continuity of Patient Care; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006773:Hospitals, Municipal / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009519:New York City / Q000453:epidemiology; D010349:Patient Compliance; D010352:Patient Dropouts; D015397:Program Evaluation; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology*
D000995:Antitubercular Agents