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Directly observed preventive therapy. Turning the tide against tuberculosis
M R Kohn1, M R Arden, J Vasilakis
1Department of Pediatrics, Schneider Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY, USA.
Archives of Pediatrics & Adolescent Medicine
|July 1, 1996
Summary
Directly observed preventive therapy (DOPT) significantly increased tuberculosis treatment compliance in students compared to daily therapy. This school-based approach is effective for prophylactic treatment, improving adherence rates.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Tuberculosis Prevention
Background:
- Tuberculosis (TB) remains a significant public health concern, particularly in school settings.
- Ensuring compliance with prophylactic treatment for latent tuberculosis infection is crucial for preventing disease progression.
Purpose of the Study:
- To compare treatment compliance between directly observed preventive therapy (DOPT) and daily therapy for students with inactive tuberculosis (class II).
Main Methods:
- A cohort analytic study was conducted in an inner-city New York high school.
- Students with positive purified protein derivative (PPD) and negative chest x-rays received isoniazid prophylaxis.
- Treatment was administered either via DOPT in a school clinic or daily therapy through the Department of Health.
Main Results:
- Directly observed preventive therapy (DOPT) completion rate was 87.6%, significantly higher than the 50% completion rate for daily therapy (P = 0.001).
- DOPT was administered by existing school personnel without additional cost.
- The study screened 864 students, with 161 identified as needing prophylactic treatment.
Conclusions:
- Directly observed preventive therapy (DOPT) is a highly effective strategy for improving tuberculosis prophylactic treatment compliance in school settings.
- Implementing DOPT in school clinics can enhance adherence and contribute to TB control efforts.