title: [Directly observed treatment for tuberculosis in a Buenos Aires City hospital].
abstract: The outcomes of directly observed therapy of tuberculosis (DOT) between 1/1/1979 and 12/31/2009 were analyzed. Results obtained in the 1979-1999 period were compared with those achieved in the 2000-2009 period. In a Buenos Aires City hospital, 582 HIV negative TB patients received rifampin, isoniazid, pyrazinamide and ethambutol or streptomycin in the initial stage, followed by a second stage where patients were included in two groups: G1 composed by 424 patients (period 1/1/1979-12/31/1999) who received either rifampin and isoniazid or rifampin and streptomicin twice a week, and G2, with 158 patients (period 1/1/2000-12/31/2009) who received either rifampin and isoniazid twice or three times a week. National and Buenos Aires City TB Control Programs recommendations were followed. Patients who underwent DOT had higher completeness rates than those included in self-administered therapy (82.8% vs. 48.7%), (p <0.0001). Mean age: 36.3 ± 15.3 years, males: 63.1% and 69.4% were Argentine citizens. A 8.9% had been previously treated, 6.1% had co-morbidities. A 70.6% of pulmonary cases was bacteriologically confirmed, 82.8% of them completed the treatment, while 11.5% defaulted. Adverse effects to antituberculosis drugs were observed in 9.5% of cases; male patients showed higher rates of non adherence. G2 had a lower proportion of native people (48.7% vs. 77.1%), (p = 0.0001), higher frequency of co-morbidities (10.7% vs. 4.4%), (p = 0.005), of bacteriologically confirmed pulmonary cases (95% vs. 87%), (p = 0.02) and more adverse effects than G1 (17% vs. 6.6%), (p = 0.0001). In coincidence with other experiences, this work shows high treatment success rates in patients treated under DOT strategy.
authors.affiliation: Unidad Neumotisiología, Hospital J.M. Ramos Mejía, Buenos Aires, Argentina. claudiogonzales.57@hotmail.com
authors.forename: Claudio
authors.initials: C
authors.lastname: González
authors.forename: César
authors.initials: C
authors.lastname: Sáenz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Herrmann
authors.forename: Mónica
authors.initials: M
authors.lastname: Jajati
authors.forename: Paula
authors.initials: P
authors.lastname: Kaplan
authors.forename: Dora
authors.initials: D
authors.lastname: Monzón
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001118:Argentina; D023801:Directly Observed Therapy; D004359:Drug Therapy, Combination / Q000379:methods; D004977:Ethambutol / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D011718:Pyrazinamide / Q000008:administration & dosage / Q000009:adverse effects; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects; D012646:Self Administration; D013307:Streptomycin / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin