Directly-Observed and Self-Administered Tuberculosis Treatment in a Chronic, Low-Intensity Conflict Setting in India
| Autor: | Sunita Abraham, Edward Armstrong, Ramesh B. Babu, Mrinalini Das, Ihtesham A. Qureshi, Homa Mansoor, Anil Kumar Mudimanchi, Nagendra Prasad, Andrea Claes, Nirmala Rani Gundipudi, Petros Isaakidis |
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| Rok vydání: | 2014 |
| Předmět: |
Bacterial Diseases
Male Pediatrics Social Sciences lcsh:Medicine Self Administration Global Health Cohort Studies Health services Health care Medicine and Health Sciences Public and Occupational Health lcsh:Science Multidisciplinary Geography Infectious Diseases Treatment Outcome Research Design Observational Studies Female Behavioral and Social Aspects of Health Research Article Adult medicine.medical_specialty Tuberculosis Clinical Research Design Adverse outcomes India Human Geography Research and Analysis Methods medicine Humans Lost to follow-up Psychiatry Primary Care Directly Observed Therapy Retrospective Studies Demography business.industry lcsh:R medicine.disease Health Care Internally displaced person Chronic Disease Earth Sciences lcsh:Q Observational study business |
| Zdroj: | PLoS ONE, Vol 9, Iss 3, p e92131 (2014) PLoS ONE |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0092131 |
| Popis: | Background Limited data are available about tuberculosis treatment models of care for internally displaced populations in chronic, low-intensity conflict zones. This study aimed to detail experiences of a Medecins Sans Frontieres tuberculosis programme in Andhra Pradesh-Chhattisgarh border area, India, from January to December 2012. Methods The study was a description of two retrospective, observational cohorts receiving category I tuberculosis treatment, either intermittent directly observed treatment (DOT) or daily self-administered therapy (SAT) depending on the security of the area and access to health care services. Results A total of 55 and 17 new tuberculosis patients under DOT and SAT respectively, with complete outcomes were included in the study. Most patients registered were new cases suffering from pulmonary, smear-positive tuberculosis. More than half of the patients in both cohorts were cured or completed treatment: 38/55 (69%) patients were successfully treated under DOT compared to 9/17 (53%) under SAT. Of the patients with adverse outcomes, the ratios of loss to follow up: failure: died were 10∶4:3 under DOT and 7∶0:1 under SAT. A much smaller proportion of patients under DOT (18%) were lost to follow up than under SAT (41%). Discussion Maximum efforts are required to implement successful tuberculosis control programmes for internally displaced populations in conflict zones. Our study suggests that complete tuberculosis treatment can be given to patients using either intermittent DOT or daily SAT, depending on security and access to health services. National TB programmes should include SAT strategies for tuberculosis treatment as these may be an alternative feasible option in conflict settings. |
| Databáze: | OpenAIRE |
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