Results of directly observed treatment for tuberculosis in Ensenada, Mexico: not all DOTS programs are created equally.
METHODS
Tuberculosis (TB) program in Ensenada, Mexico.


OBJECTIVE
To evaluate the impact of the DOTS strategy on adherence and cure rates in everyday practice.


METHODS
Retrospective analysis of 629 patients diagnosed with TB.


RESULTS
A total of 70% of the patients under directly observed treatment (DOT) were cured vs. 72.8% of those under self-administered treatment (SAT, P = 0.57). There was no difference on the length of therapy according to treatment regimen (4.82 +/- 2.41 for DOT vs. 4.93 +/- 2.16 for SAT, P = 0.61); 16.8% of patients under DOT abandoned treatment vs. 14.1% in the SAT group (P = 0.40). Logistic regression analysis confirmed the previous findings, with length of treatment under 6 months being the strongest predictive variable for treatment failure (OR 18.8, P < 0.00). The type of regimen (DOT vs. SAT) was not predictive of treatment failure (OR for failure for SAT regimen 0.65, P = 0.14).


CONCLUSIONS
Cure and completion of treatment rates in our population under study did not differ significantly when comparing DOT vs. SAT. Those in charge of the DOTS programs in a given country need to assess which are the most important ingredients for success in their particular program.
Radilla-Chávez
P
P
Graduate School of Public Health, Universidad Autónoma de Baja California, Tijuana, México.
Laniado-Laborín
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000592:standards*; D023801:Directly Observed Therapy / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents