Direct observation of tuberculosis treatment by supervised family members in Yasothorn Province, Thailand.
METHODS
Yasothorn Province, Thailand.


OBJECTIVE
To evaluate the effectiveness of a programme offering the option of direct observation of treatment (DOT) by a supervised family member.


METHODS
Review of patient records and district registers in Yasothorn Province after implementation of the revised tuberculosis control strategy.


RESULTS
From 1 October 1996 to 30 September 1997, the programme registered 779 patients: 366 smear-positive pulmonary, 357 smear-negative pulmonary, and 56 extra-pulmonary. DOT was given in 243 (66%) smear-positive, 83 (23%) smear-negative, and in 21 (38%) extra-pulmonary cases; the observer was a family member in 299 (86.2%) of the 347 cases. By December 1998, treatment outcomes were determined for the 695 new patients (326 smear-positive, 321 smear-negative, 48 extra-pulmonary) of the 779 registered during the period under study. In new smear-positive patients, cure rates were 184/216 (85.2%, 95% confidence interval [CI] 80.5-89.9) with DOT versus 78/110 (70.9%, 95% CI 62.4-79.4) with self-administration.


CONCLUSIONS
The overall cure rate was 80.4% in a programme in which trained and supervised family members directly observed the treatment of two-thirds of sputum smear-positive patients. Supervised family members may contribute to more widespread effective implementation of the revised tuberculosis strategy in Thailand.
Akkslip
S
S
Seventh Region Communicable Disease Control, Ubonratchathani, Thailand.
Rasmithat
S
S
Maher
D
D
Sawert
H
H
D003140:Communicable Disease Control / Q000379:methods; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D013785:Thailand; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000517:prevention & control*