Can guardians supervise TB treatment as well as health workers? A study on adherence during the intensive phase
METHODS: In Ntcheu district, Malawi, a new TB regimen was introduced from April 1996 in which patients received supervised treatment by either a health worker or a guardian (i.e., family member). Adherence to the different treatment options was measured by form checks, tablet counts, and tests for detecting isoniazid in the urine. Adherence was measured at 2, 4 and 8 weeks after onset of TB treatment.
RESULTS: Overall adherence rate was 95–96%. In-patients showed the highest adherence rates. Patients on guardian-based DOT (GB-DOT) (n = 35) showed 94% adherence, while patients on health centre based DOT (n = 40) showed more non-adherent behaviour: 11% according to monitoring forms, 14% according to tablet counts and 16% according to urine tests.
DISCUSSION: The results suggest that decentralised care is a feasible option for anti-tuberculosis treatment and that guardians can supervise TB treatment just as well as health workers during the intensive phase of TB treatment.
Document Type: Regular Paper
Affiliations: 1: Department of Health Education and Promotion, University of Maastricht, Maastricht, The Netherlands 2: National Tuberculosis Control Programme, Community Health Science Unit, Lilongwe, Malawi 3: Department of Psychology, University of Maastricht, Maastricht, The Netherlands
Publication date: 2001-09-01
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