A comparison of two methods of undertaking directly observed therapy in a rural indian setting
A Mathew1, C Binks, J Kuruvilla
1Nav Jivan Hospital, Palamu, Jharkhand, India.
Setting:
Jharkhand State, rural India.
Objectives:
To compare the completion rates of the two tuberculosis control programmes of the Nav Jivan Hospital, Tumbagara, and to show that even in difficult areas, a DOTS programme can be successfully implemented.
Design:
A retrospective analysis of two DOTS programmes centred on a small rural hospital based on an analysis of case outcome.
Methods:
Comparative study between two ways of delivering a DOTS programme.
Results:
At the end of the treatment period, 359 patients in the hospital unsupervised programme and 158 in the directly observed and hospital checked programme were available for analysis. Completion/cure rates were 64% in the former group and 89.2% in the latter, compared with completion/cure rates of 17% before either programme was adopted. Sputum smear positivity rates were 79.3% and 76.5%, respectively, compared with 6% before the programmes.
Conclusions:
A hospital supervised and directly observed treatment (DOT) programme using independent DOT observers can exceed WHO targets for cure/ completion rates even in the poorest rural setting.
Related Concept Videos
Naturalistic Observations
Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One example of...
Blind Procedures
Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.

