Free Content TB treatment: as simple as DOT? [Counterpoint]

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Abstract:

Treatment completion continues to be an unmet challenge in tuberculosis (TB) control worldwide. Since the introduction of DOTS by the World Health Organization in 1993, directly observed therapy (DOT) has been promoted as the centerpiece of the strategy. The results of three randomized controlled studies designed to evaluate the effects of DOT on treatment completion, and carried out in South Africa, Thailand and Pakistan, showed conflicting results. It is doubtful that any of the studies provided valid measures of the effectiveness of DOT. Each study operationalized DOT in ways that did not match the study definition and failed to account for additional study interventions in their analyses. Given the evidence, there is no one factor that is ‘the’ answer to the challenge of TB treatment completion.

Keywords: DOT; adherence; treatment completion; tuberculosis

Document Type: Miscellaneous

Affiliations: 1: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA 2: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA; and Department International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA

Publication date: July 1, 2003

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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