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Free Content Treatment interruption and directly observed treatment of multidrug-resistant tuberculosis patients in China

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BACKGROUND: China has nearly one fifth of global multidrug-resistant tuberculosis (MDR-TB) cases, and follows the 24-month World Health Organization (WHO) standardised regimens.

OBJECTIVE: To assess treatment interruption among MDR-TB patients and its association with the provision of directly observed treatment (DOT).

METHODS: We reviewed clinical charts and conducted a questionnaire survey among all confirmed MDR-TB patients who had been treated for at least 6 months from 1 January 2009 to 30 April 2012 in Shandong Province. Treatment interruption was defined as missing a dose for at least 1 day but for <8 consecutive weeks; the subset ‘severe interruption' was defined as missing doses for 2–8 consecutive weeks.

RESULTS: Of 110 patients, 75 (68%) interrupted treatment; 19 (17%) reported severe interruption, with a median duration of 30 days. Of the 110 patients, 26 (24%) received injections from family members and 55 (50%) received DOT, 7 (13%) from village doctors and 48 (87%) from family members. Patients who underwent DOT with a family member had less severe interruptions (OR 0.25, 95%CI 0.05–0.98) than those who were given DOT by a village doctor or who did not undergo DOT.

CONCLUSIONS: Family members may act as treatment supporters for MDR-TB patients to reduce treatment interruptions, but require orientation on their role.
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Keywords: DOT; MDR-TB; community management; family members; treatment interruption

Document Type: Research Article

Affiliations: 1: The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 2: Nuffield Centre for International Health and Development, University of Leeds China Office, Shenzhen, China 3: Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK 4: Center for TB Control, Shandong Provincial Chest Hospital, Jinan, China 5: Center for Health Management and Policy, Shandong University, Jinan, China 6: National Centre for TB Control and Prevention, China Centre for Disease Control, Beijing, China

Publication date: 2015-04-01

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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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