Family Based Directly Observed Therapy on Culture Conversion in Newly Diagnosed Pulmonary Tuberculosis Patients

摘要

Background: The effectiveness of directly observed therapy (DOT) on TB treatment outcome has been debated and different findings regarding different DOT practices and settings were demonstrated. Methodology: The observational study was conducted in new sputum smear and culture positive pulmonary TB patients at Queen Savang Vadhana Memorial Hospital and Chonburi Hospital, Chonburi province, Thailand during April 2010 and July 2012. The aim of this study was to evaluate the effect of family based DOT toward sputum culture conversion. Sputum AFB smear, culture and drug susceptibility test were performed at the time of diagnosis, the second and the fifth month of treatment. Baseline characteristic, clinical and laboratory parameters, treatment regimens and adverse events were recorded. Descriptive statistics were applied as appropriate. Results: Proportion of patients with illiteracy, visual alteration and hepatitis was significantly higher in family based DOT group (p=0.026, p=0.011 and p=0.031). Sputum smear and culture conversion at 2 and 5 months after treatment were not significantly different between family based DOT and self administer groups. Patients in both group achieved over 90% cure rate without significant difference (p=0.262). Conclusions: Continuing patient education, counseling and AEs monitoring should be incorporated into family based DOT to achieved successful outcome. DOT can be interfered by many factors. Therefore appropriate implementing of DOT can enhance effectiveness of DOT toward patient adherence and further achieve success in TB treatment and control.