Abdul Rahman Faisal, Rizwan Aziz Qazi, Muhammad Iqbal, Javaid Waseemuddin, Faizah Rehmani, Tabinda Bashir.
Effectiveness of directly observed treatment strategy (DOTS) as compared to self-administered therapy in Tuberculosis.
Ann Pak Inst Med Sci Jan ;1(2):79-83.

Background: Directly Observed Treatment Strategy (DOTS) has been advocated for use to achieve a more effective control of tuberculosis. Objective: To study the effectiveness of DOTS in comparison to self-administered therapy in our setting. Design: Comparative interventional study. Place and Duration of Study: It was conducted at the TB section of POFs Hospital, Wah Cantonment over a period of 14 months commencing from November 2001 to January 2003. Subjects and Methods: We enrolled 100 adults with freshly diagnosed sputum positive tuberculosis. Thirty four patients were assigned DOTS with direct observation of treatment by a health-worker; 34 patients were assigned DOTS with direct observation of treatment by family-members; and 32 patients were assigned self-administered treatment. All patients were administered with a standard daily short course anti-tuberculous drug regimen (2 months of isoniazid, rifampicin, pyrazinamide and ethambutol followed by 4 months of isoniazid and ethambutol). Subsequently results were analyzed. Results: The health-worker DOTS, family-member DOTS and self-administered treatment strategies gave very similar outcomes, with cure rates of 65%, 53% and 63% respectively, and cure or treatment completion rates of 76%, 76% and 75% respectively. Conclusion: None of the three strategies tested was found to be superior to the others. Direct observation of treatment did not give any additional improvement in cure rates.

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