Success of community-based directly observed anti-tuberculosis treatment in Mongolia
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...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
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Churchill Livingstone, Journal production department
2015
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| Online Access: | http://hdl.handle.net/20.500.11937/53747 |
| _version_ | 1848759218535923712 |
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| author | Dobler, C. Korver, S. Batbayar, O. Oyungtsetseg, S. Tsolmon, B. Wright, Cameron Solongo, B. Marais, B. |
| author_facet | Dobler, C. Korver, S. Batbayar, O. Oyungtsetseg, S. Tsolmon, B. Wright, Cameron Solongo, B. Marais, B. |
| author_sort | Dobler, C. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T09:56:23Z |
| format | Journal Article |
| id | curtin-20.500.11937-53747 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:56:23Z |
| publishDate | 2015 |
| publisher | Churchill Livingstone, Journal production department |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-537472017-11-15T03:36:00Z Success of community-based directly observed anti-tuberculosis treatment in Mongolia Dobler, C. Korver, S. Batbayar, O. Oyungtsetseg, S. Tsolmon, B. Wright, Cameron Solongo, B. Marais, B. 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/53747 10.5588/ijtld.14.0927 Churchill Livingstone, Journal production department fulltext |
| spellingShingle | Dobler, C. Korver, S. Batbayar, O. Oyungtsetseg, S. Tsolmon, B. Wright, Cameron Solongo, B. Marais, B. Success of community-based directly observed anti-tuberculosis treatment in Mongolia |
| title | Success of community-based directly observed anti-tuberculosis treatment in Mongolia |
| title_full | Success of community-based directly observed anti-tuberculosis treatment in Mongolia |
| title_fullStr | Success of community-based directly observed anti-tuberculosis treatment in Mongolia |
| title_full_unstemmed | Success of community-based directly observed anti-tuberculosis treatment in Mongolia |
| title_short | Success of community-based directly observed anti-tuberculosis treatment in Mongolia |
| title_sort | success of community-based directly observed anti-tuberculosis treatment in mongolia |
| url | http://hdl.handle.net/20.500.11937/53747 |