A comparison of two methods of undertaking directly observed therapy in a rural indian setting.
METHODS
Jharkhand State, rural India.


OBJECTIVE
To compare the completion rates of the two tuberculosis control programmes of the Nav Jivan Hospital, Tumbagara, and to show that even in difficult areas, a DOTS programme can be successfully implemented.


METHODS
A retrospective analysis of two DOTS programmes centred on a small rural hospital based on an analysis of case outcome.


METHODS
Comparative study between two ways of delivering a DOTS programme.


RESULTS
At the end of the treatment period, 359 patients in the hospital unsupervised programme and 158 in the directly observed and hospital checked programme were available for analysis. Completion/cure rates were 64% in the former group and 89.2% in the latter, compared with completion/cure rates of 17% before either programme was adopted. Sputum smear positivity rates were 79.3% and 76.5%, respectively, compared with 6% before the programmes.


CONCLUSIONS
A hospital supervised and directly observed treatment (DOT) programme using independent DOT observers can exceed WHO targets for cure/ completion rates even in the poorest rural setting.
Mathew
A
A
Nav Jivan Hospital, Palamu, Jharkhand, India.
Binks
C
C
Kuruvilla
J
J
Davies
P D
PD
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D023801:Directly Observed Therapy / Q000379:methods*; D005260:Female; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D012424:Rural Population; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents