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    Success of community-based directly observed anti-tuberculosis treatment in Mongolia

    252617.pdf (607.4Kb)
    Access Status
    Open access
    Authors
    Dobler, C.
    Korver, S.
    Batbayar, O.
    Oyungtsetseg, S.
    Tsolmon, B.
    Wright, Cameron
    Solongo, B.
    Marais, B.
    Date
    2015
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Dobler, C. and Korver, S. and Batbayar, O. and Oyungtsetseg, S. and Tsolmon, B. and Wright, C. and Solongo, B. et al. 2015. Success of community-based directly observed anti-tuberculosis treatment in Mongolia. The International Journal for Tuberculosis and Lung Disease. 19 (6): pp. 657-662.
    Source Title
    The international journal for tuberculosis and lung disease
    DOI
    10.5588/ijtld.14.0927
    ISSN
    1027-3719
    School
    Department of Health Policy and Management
    Remarks

    Copyright © 2015 The Union

    URI
    http://hdl.handle.net/20.500.11937/53747
    Collection
    • Curtin Research Publications
    Abstract

    BACKGROUND: Many countries restrict access to directly observed therapy (DOT) for tuberculosis (TB) to government health facilities. More innovative approaches are required to reduce non-adherence, improve patient outcomes and limit the risk of selecting drug-resistant strains. METHODS: We performed a retrospective cohort study in sputum smear-positive patients treated with community-based DOT (home-based DOT or 'lunch' DOT, whereby DOT is provided with a free daily meal once sputum smear conversion has been documented), and conventional clinic-based DOT in Ulaanbaatar, the capital of Mongolia, in 2010-2011. We compared treatment success using community-based home DOT vs. conventional clinic DOT and describe treatment completion rates using lunch DOT. RESULTS: The overall treatment success among new sputum smear-positive TB patients was 85.1% (1505/1768). Patients receiving community DOT had higher cure rates (294/327, 89.9% vs. 1112/1441, 77.2%; aOR 2.66, 95%CI 1.81-3.90) and higher treatment success (306/327, 93.6% vs. 1199/1441, 83.2%; aOR 2.95, 95%CI 1.85-4.71, P < 0.001) than those treated with clinic DOT. Apart from one death, treatment completion was 100% among patients who received lunch DOT after sputum smear conversion. CONCLUSIONS: Community DOT improved treatment success in Ulaanbaatar, Mongolia. It should now be scaled up to be made available for more patients and in all regions of the country.

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