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Improvement in Tuberculosis Outcomes With a Combined Medical and Social Approach.
Jesica Mazza-Stalder1,2, Emilie Chevallier1, Onya Opota3
1Pulmonary Division, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Directly observed therapy (DOT) and enhanced social support significantly improved tuberculosis treatment success in Switzerland. This combined approach led to a 90.1% global success rate, particularly benefiting asylum seekers.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Tuberculosis (TB) treatment outcomes in Switzerland were unsatisfactory in the late eighties.
- Improvements were noted following the introduction of directly observed therapy (DOT) in the late nineties and increased social support.
- Recent years have seen further enhancements in TB care management.
Purpose of the Study:
- To evaluate tuberculosis treatment outcomes in Vaud County (VD), Switzerland.
- To assess the impact of directly observed therapy (DOT) and social support on treatment success.
- To analyze outcomes for all notified tuberculosis patients between 2010 and 2014.
Main Methods:
- Retrospective study of tuberculosis patients notified in Vaud County, Switzerland.
- Data collected from January 1, 2010, to December 31, 2014.
- Analysis of global treatment outcomes, cure rates, treatment completion, and the application of DOT, including for asylum seekers.
Main Results:
- A total of 375 tuberculosis patients were notified during the study period.
- The global treatment success rate was 90.1% (338/375).
- For culture and PCR-positive pulmonary TB, the treatment success rate was 90.2% (183/183), with a cure rate of 57.9% and treatment completion of 32.2%.
- Directly observed therapy (DOT) was used in 62.4% of patients.
- Treatment outcomes for asylum seekers were successful in 89.6% (60/67).
Conclusions:
- The introduction of DOT and a greater focus on social support for migrants have improved tuberculosis treatment outcomes in Vaud County.
- A combined medical and social approach to tuberculosis care is effective in enhancing treatment success.
- Continued attention to both clinical and social aspects is crucial for managing tuberculosis effectively.
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