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Updated: Jul 12, 2026

The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Effect of World Health Organization Module-based Training on Performance of Directly Observed Treatment, Short-course
Suseendar Shanmugasundaram1, T B Pritish Baskaran2, Akhil Dhanesh Goel3
1Consultant (Medical), Division of Health Systems Research, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India.
Background:
Poor counseling by healthcare providers contributes to dissatisfaction and poor treatment adherence among people with tuberculosis (TB).
Objectives:
The objective of the study was to assess the effect of counseling training on directly observed treatment, short-course (DOTS) provider performance and patient outcomes in TB care.
Materials And Methods:
A community-based intervention study was conducted in two TB units of Jodhpur, with one receiving the World Health Organization (WHO)-based counseling training and the other serving as a control. Knowledge, attitude, and practice (KAP) and counseling skills of healthcare workers, patient satisfaction, and medication adherence were assessed pre- and postintervention.
Results:
Posttraining, healthcare workers in the intervention unit showed significant improvement in KAP and counseling skills compared to baseline and control units ( P < 0.001). Attitude scores improved marginally. Patient satisfaction and medication adherence showed modest improvement, but the difference-in-difference analysis showed no statistically significant change.
Conclusion:
WHO module-based training improves DOTS provider counseling, but patient outcomes need broader system and community support.
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