[Effect of shortened directly observed treatment on compliance and cure rate of pulmonary tuberculosis].
OBJECTIVE
To evaluate shortened directly observed treatment (DOTS) for management of pulmonary tuberculosis and to compare its outcomes with self-administered therapy (SAT).


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.
Martínez-Medina
Miguel A
MA
Servicio de Medicina Preventiva, Unidad de Medicina Familiar No. 37, Instituto Mexicano del Seguro Social, Hermosillo, Sonora, México.
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012074:Remission Induction; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents