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Free Content Increasing directly observed therapy related to improved tuberculosis treatment outcomes in Taiwan

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SETTING: Directly observed therapy (DOT) is a core element of tuberculosis (TB) care and control efforts. In Taiwan, DOT was implemented in 2006, when the Stop TB Strategy was adopted as a national policy.

OBJECTIVE: To quantify DOT among patients on anti-tuberculosis treatment and measure the association between proportion of DOT and TB treatment outcomes at a national level in Taiwan.

DESIGN: We analyzed data prospectively collected on all new pulmonary TB cases reported to the national web-based registry between 1 January 2007 and 30 June 2008. We compared treatment outcomes and proportion of DOT in multivariable analyses.

RESULTS: Among 11 528 patients initiating anti-tuberculosis treatment, the proportion of days during which an official DOT observer witnessed treatment was >60% for 5150 (45%) patients and ≤60% for 4601 (40%) patients, whereas for 1777 (15%) patients no days of DOT were recorded. Being older, male, having positive bacteriology results and a non-World Health Organization recommended treatment regimen at baseline were independently related to unsuccessful treatment outcomes and mortality. A dose-response effect was found between proportion of DOT and these outcomes.

CONCLUSION: These findings highlight the importance of ensuring universal DOT in improving treatment outcomes among new pulmonary TB patients.
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Keywords: Taiwan; directly observed therapy; treatment outcomes; tuberculosis

Document Type: Research Article

Affiliations: 1: US Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: Taiwan Centers for Disease Control, Taipei, Taiwan

Publication date: 01 April 2012

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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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