A novel approach to directly observed therapy for Tuberculosis in an HIV-endemic area

Moïse DESVARIEUX, Pierre-Richard HYPPOLITE, Warren D. JOHNSON, Jean W. PAPE

Am J Public Health. 2001 January; 91(1): 138–141


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.

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