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Free Content Directly observed treatment of tuberculosis in Hong Kong

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OBJECTIVE: To evaluate the local use of out-patient directly observed treatment (DOT) for tuberculosis (TB) control.

SETTING: Seventeen government chest clinics managing around 80% of TB patients in Hong Kong.

METHOD: A retrospective cohort. TB patients registered for treatment from 1 July to 31 August 2000 were followed up for 2 years. Baseline socio-demographic and clinical characteristics were correlated with adherence to DOT, mode of treatment and treatment outcomes.

RESULTS: Of 988 patients, respectively 142, 140 and 21 switched to non-DOT within 2 months, 2–6 months and after 6 months. More Chinese patients than ethnic minorities switched to non-DOT within the first 2 months (15.2% vs. 0%, P = 0.001). Geographical inconvenience (31.7%) was the primary reason for switching initially, with increasing proportions giving no specific reason after the second month. Patients staying on DOT in the first 2 months had a significantly higher cure rate than those not on DOT, in both univariate (92.7% vs. 83.9%, P = 0.002) and multivariate analysis (OR = 2.5, P = 0.001). Subsequent switching, intermittent or daily regimen did not appear to affect the outcome.

CONCLUSION: Significant numbers of patients failed to stay on DOT, and those staying initially had a better outcome.
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Keywords: DOTS; treatment; tuberculosis

Document Type: Regular Paper

Affiliations: Tuberculosis and Chest Service, Department of Health, Hong Kong, China

Publication date: 2005-04-01

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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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