b) Measures to Improve Treatment Adherence
AU : Jagota P, Balasangameshwara VH, Jayalakshmi MJ & Islam MM
TI : An alternative method of providing supervised Short Course Chemotherapy in District Tuberculosis Programme
SO : Indian J TB 1997, 44, 73-77
DT : Per
AB :

The feasibility of involving ‘Dai’s’ in supervised administration of an oral 6-month SCC regimen in DTP was studied in 2 districts. A concurrent comparison was made between the Dai Method and the present DTP procedure, called the PHI Method, in terms of treatment completion and cure rates at the end of treatment period. A total of 617 patients were observed; 332 in Dai method and 285 in PHI method. About 68% of patients in the Dai method and 33% in the PHI method took more than 75% of treatment in both intensive and continuation phases. The outcome in terms of smear negativity at the end of treatment period was 86.9% and 72.2% respectively. There were 17 (5.72%) deaths in the Dai method and 16 (8.5%) in the PHI method. Treatment completion and cure rates were significantly higher in the Dai method. It is concluded that Dais can be used for supervised drug administration in DTP for increasing the cure rates.


Patient Education at Door Steps

AU : Jagota P, Sujatha Chandrasekaran & Sumathi G
TI : Follow-up of Pulmonary Tuberculosis patients treated with Short Course Chemotherapy through traditional birth attendants (Dais)
SO : Indian J TB 1998, 45, 89-93.
DT : Per
AB :

The feasibility of improving adherence to and outcome of treatment among smear positive pulmonary tuberculosis patients by involving traditional birth attendants (Dais) in administering anti-tuberculosis drugs was earlier studied and 86.9% were reported to be cured, 5.72% had died and 7.38% had remained sputum positive, at the end of 6 months. The present study reports the status of those patients at the end of 2 years. Of the 288 patients eligible for follow up, 283 could be contacted through home visits and interviewed for the presence of symptoms and further treatment taken; if dead, the cause of death was ascertained from relatives. Two sputum specimens were also collected from the contacted patients for microscopy, culture and drug sensitivity tests. At the end of 2 years, 79.6% had remained relapse free 7.42% had relapsed and 3.53% remained sputum positive (chronic cases) while 8.5% had died. Of the 251 patients interviewed, 131 still had chest symptoms, 2 years after treatment, but only 24 of them had bacteriologically positive disease. The remaining 7 sputum positive cases were either having non suggestive symptoms or no symptoms.

In view of the above findings, it is considered that DOTS delivered through Dais is feasible