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Free Content A comparison of two methods of undertaking directly observed therapy in a rural Indian setting

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SETTING: Jharkhand State, rural India.

OBJECTIVES: To compare the completion rates of the two tuberculosis control programmes of the Nav Jivan Hospital, Tumbagara, and to show that even in difficult areas, a DOTS programme can be successfully implemented.

DESIGN: A retrospective analysis of two DOTS programmes centred on a small rural hospital based on an analysis of case outcome.

METHODS: Comparative study between two ways of delivering a DOTS programme.

RESULTS: At the end of the treatment period, 359 patients in the hospital unsupervised programme and 158 in the directly observed and hospital checked programme were available for analysis. Completion/cure rates were 64% in the former group and 89.2% in the latter, compared with completion/cure rates of 17% before either programme was adopted. Sputum smear positivity rates were 79.3% and 76.5%, respectively, compared with 6% before the programmes.

CONCLUSIONS: A hospital supervised and directly observed treatment (DOT) programme using independent DOT observers can exceed WHO targets for cure/completion rates even in the poorest rural setting.

Keywords: DOT; completion; rural India; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Nav Jivan Hospital, Palamu, Jharkhand, India 2: Cardiothoracic Centre, Tuberculosis Research Unit, Liverpool, Mersey, United Kingdom

Publication date: 2005-01-01

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  • 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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