| Autor: |
R, Fatima, A, Yaqoob, E, Qadeer, M A, Khan, A, Ghafoor, B, Jamil, M U, Haq, N, Ahmed, S, Baig, A, Rehman, Q, Abbasi, A W, Khan, A, Ikram, J P, Hicks, J, Walley |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
The International Journal of Tuberculosis and Lung Disease. 26:929-933 |
| ISSN: |
1027-3719 |
| DOI: |
10.5588/ijtld.21.0695 |
| Popis: |
BACKGROUND Multidrug-resistant TB (MDR-TB) treatment takes 18–24 months and is complex, costly and isolating. We provide trial evidence on the WHO Pakistan recommendation for community-based care rather than hospital-based care.METHODS Two-arm, parallel-group, superiority trial was conducted in three programmatic management of drug-resistant TB hospitals in Punjab and Sindh Provinces, Pakistan. We enrolled 425 patients with MDR-TB aged >15 years through block randomisation in community-based care (1-week hospitalisation) or hospital-based care (2 months hospitalisation). Primary outcome was treatment success.RESULTS Among 425 patients with MDR-TB, 217 were allocated to community-based care and 208 to hospital-based care. Baseline characteristics were similar between the community and hospitalised arms, as well as in selected sites. Treatment success was 74.2% (161/217) under community-based care and 67.8% (141/208) under hospital-based care, giving a covariate-adjusted risk difference (community vs. hospital model) of 0.06 (95% CI –0.02 to 0.15; P = 0.144).CONCLUSIONS We found no clear evidence that community-based care was more or less effective than hospital-based care model. Given the other substantial advantages of community-based care over hospital based (e.g., more patient-friendly and accessible, with lower treatment costs), this supports the adoption of the community-based care model, as recommended by the WHO. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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