The impact of intensified supervisory activities on tuberculosis treatment

A Health Subcentre-based randomized controlled trial was conducted in order to determine the importance of the motivation of the tuberculosis personnel in improving the results of a treatment programme. A total of 1300 newly detected tuberculosis patients from 7 Health Centres were divided into study and control groups using the Health Subcentre areas as sampling units. In the study group, worker motivation was intensified through special regular sessions and closer supervision, while in the control group the usual procedures were followed. Treatment performance was remarkably improved in the study areas: treatment completion rate was 78.8% in the study group, compared with 65.2% in the control group. Bacteriological conversions among those having completed the treatment were 91.9% and 62.2% respectively, and overall efficacy was 75.2% and 45.8%, respectively. In addition to improved treatment, the follow-up case examinations also showed markedly increased performance. Although this study was done in facilities using conventional regimens which have been replaced with short-course regimens more recently, the study results still clearly indicate the importance of motivating personnel in the field to attain better case management.