Directly observed treatment of tuberculosis in Hong Kong.
OBJECTIVE
To evaluate the local use of out-patient directly observed treatment (DOT) for tuberculosis (TB) control.


METHODS
Seventeen government chest clinics managing around 80% of TB patients in Hong Kong.


METHODS
A retrospective cohort. TB patients registered for treatment from 1 July to 31 August 2000 were followed up for 2 years. Baseline socio-demographic and clinical characteristics were correlated with adherence to DOT, mode of treatment and treatment outcomes.


RESULTS
Of 988 patients, respectively 142, 140 and 21 switched to non-DOT within 2 months, 2-6 months and after 6 months. More Chinese patients than ethnic minorities switched to non-DOT within the first 2 months (15.2% vs. 0%, P = 0.001). Geographical inconvenience (31.7%) was the primary reason for switching initially, with increasing proportions giving no specific reason after the second month. Patients staying on DOT in the first 2 months had a significantly higher cure rate than those not on DOT, in both univariate (92.7% vs. 83.9%, P = 0.002) and multivariate analysis (OR = 2.5, P = 0.001). Subsequent switching, intermittent or daily regimen did not appear to affect the outcome.


CONCLUSIONS
Significant numbers of patients failed to stay on DOT, and those staying initially had a better outcome.
Wong
M Y
MY
Tuberculosis and Chest Service, Department of Health, Hong Kong, China. chungpor@netvigator.com
Leung
C C
CC
Tam
C M
CM
Lee
S N
SN
D000368:Aged; D000553:Ambulatory Care; D000704:Analysis of Variance; D015331:Cohort Studies; D023801:Directly Observed Therapy; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*