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Directly observed therapy for tuberculosis: the Harlem Hospital experience, 1993
W el-Sadr1, F Medard, V Berthaud
1Division of Infectious Diseases, Harlem Hospital Center, New York, NY 10037, USA.
Objectives:
A directly observed therapy program was established at Harlem Hospital, New York, NY, in 1993 to promote high tuberculosis treatment completion rates.
Methods:
The Harlem program used an on-site surrogate family model. Treatment completion rate, visit adherence rate, human immuno-deficiency virus seroprevalence, and time to sputum culture conversion were assessed.
Results:
Out of 145 enrolled patients with suspected and confirmed tuberculosis, 95 (92 confirmed and 3 suspected) continued treatment. The visit adherence rate was 91.1 +/- 7.9%, with one patient (1%) lost to follow-up.
Conclusion:
High rates of treatment completion and visit adherence were achieved because of unique program characteristics. Thus, directly observed therapy is advocated as a means of ensuring treatment completion.