Objectives: This study evaluated a novel approach to the delivery of directly observed therapy (DOT) for tuberculosis in Haiti.
Methods: A total of 194 patients (152 HIV seropositive, 42 HIV seronegative) received daily unsupervised tripledrug therapy for 4 to 8 weeks, followed by twice-weekly 2-drug therapy for the remainder of the 6-month period. DOT was deferred until initiation of the twiceweekly phase
Results: A total of 169 of 194 patients (87.1%) completed the 6-month course. The program of deferred DOT had an effectiveness of 85%. Overall cost was reduced by approximately 40%.
Conclusions: Flexible approaches to DOT, integrating behavioral knowledge, cost considerations, and practicality may improve completion rates and program effectiveness.