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    Impact of Community-Based DOT On Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis

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    Cyril Jane Caanyagan Acut
    Community-based directly observed treatment (CB-DOT) for tuberculosis was found to improve treatment outcomes compared to clinic-based DOT or self-administered treatment based on a systematic review and meta-analysis of 17 studies involving over 12,000 pulmonary tuberculosis patients. Pooled results showed CB-DOT increased successful treatment completion rates, reduced death rates, and decreased patients dropping out of treatment compared to clinic-based DOT. CB-DOT also increased successful treatment and curative treatment rates compared to self-administered treatment. The review concluded that CB-DOT improved tuberculosis treatment outcomes and that further study of effective CB-DOT implementation strategies is warranted.

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    Impact of Community-Based DOT On Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis

    Uploaded by

    Cyril Jane Caanyagan Acut
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    Community-based directly observed treatment (CB-DOT) for tuberculosis was found to improve treatment outcomes compared to clinic-based DOT or self-administered treatment based on a systematic review and meta-analysis of 17 studies involving over 12,000 pulmonary tuberculosis patients. Pooled results showed CB-DOT increased successful treatment completion rates, reduced death rates, and decreased patients dropping out of treatment compared to clinic-based DOT. CB-DOT also increased successful treatment and curative treatment rates compared to self-administered treatment. The review concluded that CB-DOT improved tuberculosis treatment outcomes and that further study of effective CB-DOT implementation strategies is warranted.

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    Community-based directly observed treatment (CB-DOT) for tuberculosis was found to improve treatment outcomes compared to clinic-based DOT or self-administered treatment based on a systematic review and meta-analysis of 17 studies involving over 12,000 pulmonary tuberculosis patients. Pooled results showed CB-DOT increased successful treatment completion rates, reduced death rates, and decreased patients dropping out of treatment compared to clinic-based DOT. CB-DOT also increased successful treatment and curative treatment rates compared to self-administered treatment. The review concluded that CB-DOT improved tuberculosis treatment outcomes and that further study of effective CB-DOT implementation strategies is warranted.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    10 views2 pages

    Impact of Community-Based DOT On Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis

    Uploaded by

    Cyril Jane Caanyagan Acut
    Community-based directly observed treatment (CB-DOT) for tuberculosis was found to improve treatment outcomes compared to clinic-based DOT or self-administered treatment based on a systematic review and meta-analysis of 17 studies involving over 12,000 pulmonary tuberculosis patients. Pooled results showed CB-DOT increased successful treatment completion rates, reduced death rates, and decreased patients dropping out of treatment compared to clinic-based DOT. CB-DOT also increased successful treatment and curative treatment rates compared to self-administered treatment. The review concluded that CB-DOT improved tuberculosis treatment outcomes and that further study of effective CB-DOT implementation strategies is warranted.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    Impact of Community-Based DOT on Tuberculosis Treatment

    Outcomes: A Systematic Review and Meta-Analysis


    Abstract

    Background

    Poor adherence to tuberculosis (TB) treatment can lead to prolonged infectivity and poor
    treatment outcomes. Directly observed treatment (DOT) seeks to improve adherence to TB
    treatment by observing patients while they take their anti-TB medication. Although community-
    based DOT (CB-DOT) programs have been widely studied and promoted, their effectiveness has
    been inconsistent. The aim of this study was to critical appraise and summarize evidence of the
    effects of CB-DOT on TB treatment outcomes.

    Methods

    Studies published up to the end of February 2015 were identified from three major
    international literature databases: Medline/PubMed, EBSCO, and EMBASE. Unpublished data
    from the grey literature were identified through Google and Google Scholar searches.

    Results

    Seventeen studies involving 12,839 pulmonary TB patients (PTB) in eight randomized controlled
    trials (RCTs) and nine cohort studies from 12 countries met the criteria for inclusion in this
    review and 14 studies were included in meta-analysis. Compared with clinic-based DOT, pooled
    results of RCTs for all PTB cases (including smear-negative or -positive, new or retreated TB
    cases) and smear-positive PTB cases indicated that CB-DOT promoted successful treatment
    [pooled RRs (95%CIs): 1.11 (1.02–1.19) for all PTB cases and 1.11 (1.02–1.19) for smear-positive
    PTB cases], and completed treatment [pooled RRs (95%CIs): 1.74(1.05, 2.90) for all PTB cases
    and 2.22(1.16, 4.23) for smear-positive PTB cases], reduced death [pooled RRs (95%CIs): 0.44
    (0.26–0.72) for all PTB cases and 0.39 (0.23–0.66) for smear-positive PTB cases], and transfer
    out [pooled RRs (95%CIs): 0.37 (0.23–0.61) for all PTB cases and 0.42 (0.25–0.70) for smear-
    positive PTB cases]. Pooled results of all studies (RCTs and cohort studies) with all PTB cases
    demonstrated that CB-DOT promoted successful treatment [pooled RR (95%CI): 1.13 (1.03–
    1.24)] and curative treatment [pooled RR (95%CI): 1.24 (1.04–1.48)] compared with self-
    administered treatment.

    Conclusions
    CB-DOT did improved TB treatment outcomes according to the pooled results of included
    studies in this review. Studies on strategies for implementation of patient-centered and
    community-centered CB-DOT deserve further attention.

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