Can guardians supervise TB treatment as well as health workers? A study on adherence during the intensive phase

摘要: SETTING: In sub-Saharan Africa, tuberculosis (TB) has increased over the last two decades due to human immunodeficiency virus pandemic. Malawi, 20630 new TB patients were notified National Tuberculosis Programme in 1996, a fourfold increase since 1986. Due this cases and lack of resources (both monetary) it is becoming more difficult ensure directly observed treatment (DOT) wards. METHODS: Ntcheu district, regimen was introduced from April 1996 which received supervised by either health worker or guardian (i.e., family member). Adherence different options measured form checks, tablet counts, tests for detecting isoniazid urine. at 2, 4 8 weeks after onset treatment. RESULTS: Overall adherence rate 95-96%. Inpatients showed highest rates. Patients on guardian-based DOT (GB-DOT) (n = 35) 94% adherence, while centre based 40) non-adherent behaviour: 11% according monitoring forms, 14% counts 16% urine tests. DISCUSSION: The results suggest that decentralised care feasible option anti-tuberculosis guardians can supervise just as well workers during intensive phase