Effectiveness of a community-based observation of anti-tuberculosis treatment in Bangalore City, India, 2010–2011

SETTING: The Revised National Tuberculosis Control Programme in an urban setting of Bangalore City, India.

OBJECTIVES: To compare treatment outcomes and smear conversion rates among new smear-positive tuberculosis (TB) patients undergoing treatment administered by community directly observed treatment (DOT) providers with those undergoing treatment administered by institutional DOT providers in Bangalore City in 2010–2011.

METHOD: Cohort study of routine data recorded from treatment cards of TB patients undergoing treatment under the public health services from 1 October 2010 to 30 September 2011.

RESULT: Treatment records of 1864 new smear-positive TB patients registered during this period were evaluated. Among those evaluated, 604 (32%) had been administered treatment by community DOT providers and the remainder by institutional DOT providers. The treatment success rate in those undergoing community DOT was 93% (n < 564) and that of those undergoing institutional DOT was 75% (n < 951; RR 1.23, 95%CI 1.19–1.28). The sputum smear conversion rate of patients who underwent community DOT was 92% and that of those who underwent institutional DOT was 71% at the end of 2 months.

CONCLUSION: We conclude that community DOT for treatment supervision of TB patients is more effective than institutional DOT and that it should be reinforced.