Directly Observed Therapy and Tuberculosis Treatment Outcomes in Thailand
Author Information
Author(s): Anuwatnonthakate Amornrat, Limsomboon Pranom, Nateniyom Sriprapa, Wattanaamornkiat Wanpen, Komsakorn Sittijate, Moolphate Saiyud, Chiengsorn Navarat, Kaewsa-ard Samroui, Sombat Potjaman, Siangphoe Umaporn, Mock Philip A., Varma Jay K.
Primary Institution: Thailand MOPH – U.S. CDC Collaboration, Nonthaburi, Thailand
Hypothesis
Does directly observed therapy (DOT) improve tuberculosis treatment outcomes in Thailand?
Conclusion
In Thailand, two months of DOT was associated with lower odds of default during treatment, with greater benefits seen when provided by a healthcare worker compared to a family member.
Supporting Evidence
- 98% of patients receiving HCW DOT remained on treatment at two months compared to 86% receiving SAT.
- 93% of patients receiving HCW DOT completed treatment compared to 69% receiving SAT.
- The study included a diverse patient population from both public and private health facilities.
Takeaway
This study found that having someone watch you take your medicine helps you stick to your treatment for tuberculosis, especially if that person is a healthcare worker.
Methodology
The study collected epidemiologic data from TB patients treated in Thailand and analyzed treatment outcomes based on the type of therapy observed.
Potential Biases
Potential misclassification of DOT status could lead to an underestimation of the benefits of DOT.
Limitations
The study did not independently verify that patients recorded as receiving DOT actually received it, which could bias the findings.
Participant Demographics
Most participants were male, aged 15-44 years, married, and from non-urban districts; 21% were HIV-infected.
Statistical Information
Confidence Interval
95% CI 2.4–6.0 for HCW DOT vs. SAT
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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