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

Desvarieux, M; Hyppolite, P R; Johnson, W D; Pape, J W · Am J Public Health · 2001

prospective_cohort · Level II

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Abstract

This study evaluated a novel approach to the delivery of directly observed therapy (DOT) for tuberculosis in Haiti. A total of 194 patients (152 HIV seropositive, 42 HIV seronegative) received daily unsupervised triple-drug 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 twice-weekly phase. 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%. Flexible approaches to DOT, integrating behavioral knowledge, cost considerations, and practicality may improve completion rates and program effectiveness.

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