Directly observed treatment of tuberculosis in Hong Kong
Abstract: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.
Document Type: Regular Paper
Affiliations: Tuberculosis and Chest Service, Department of Health, Hong Kong, China
Publication date: 2005-04-01
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