title: Implementation of the DOTS strategy in prisons at provincial level, Thailand.
abstract: METHODS
  Sixteen prisons located in four geographic regions in Thailand.
  
  
  OBJECTIVE
  To assess treatment outcomes of tuberculosis (TB) patients under the DOTS strategy in a prison programme.
  
  
  METHODS
  The programme prospectively included 1412 consecutive TB patients registered during Year 1 (June 1999-May 2000), Year 2 (June 2000-May 2001) and Year 3 (June 2001-May 2002). DOTS implementation consisted of government commitment; passive detection by sputum smear microscopy; standardised short-course chemotherapy, including directly observed treatment by prison nurses; maintenance of drug stocks at provincial health offices; and a recording and reporting system. Data were collected using prison TB registers.
  
  
  RESULTS
  The number of TB patients increased from 348 in Year 1 to 490 in Year 2 and to 574 in Year 3. New smear-positive patients accounted for 82.0% of the total. Of the 1158 new smear-positive cases, 68.7% were cured, 17.6% died, 10.6% were transferred out, 2.6% failed, and 0.5% completed treatment.
  
  
  CONCLUSIONS
  DOTS implementation in these prisons could not achieve the national target to cure 85% of new smear-positive cases. More interventions are needed to help reduce the deaths and transferred cases that mainly affected the treatment outcomes in these settings.
authors.affiliation: Tuberculosis Cluster, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Nateniyom
authors.forename: S X
authors.initials: SX
authors.lastname: Jittimanee
authors.forename: N
authors.initials: N
authors.lastname: Ngamtrairai
authors.forename: S
authors.initials: S
authors.lastname: Jittimanee
authors.forename: R
authors.initials: R
authors.lastname: Boonpendetch
authors.forename: V
authors.initials: V
authors.lastname: Moongkhetklang
authors.forename: A
authors.initials: A
authors.lastname: Prapanwong
authors.forename: W
authors.initials: W
authors.lastname: Rimwittayakorn
authors.forename: P
authors.initials: P
authors.lastname: Pokaew
authors.forename: K
authors.initials: K
authors.lastname: Aemdoung
authors.forename: S
authors.initials: S
authors.lastname: Pongpanit
authors.forename: M
authors.initials: M
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D003695:Delivery of Health Care; D003937:Diagnosis, Differential; D023801:Directly Observed Therapy; D006801:Humans; D010349:Patient Compliance; D011329:Prisoners; D012042:Registries / Q000706:statistics & numerical data*; D013183:Sputum / Q000166:cytology; D013785:Thailand; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents