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

C. C. Dobler, S. Korver, O. Batbayar, S. Oyuntsetseg, B. Tsolmon, C. Wright, B. Solongo, B. J. Marais

Research output: Contribution to journalArticleResearchpeer-review

7 Citations (Scopus)

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 drugresistant 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. RESULT S : 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 DOTimproved 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.

Original languageEnglish
Pages (from-to)657-662
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume19
Issue number6
DOIs
Publication statusPublished - 1 Jun 2015
Externally publishedYes

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Directly Observed Therapy
Mongolia
Tuberculosis
Sputum
Lunch
Therapeutics
Health Facilities
Patient Compliance

Cite this

Dobler, C. C. ; Korver, S. ; Batbayar, O. ; Oyuntsetseg, S. ; Tsolmon, B. ; Wright, C. ; Solongo, B. ; Marais, B. J. / Success of community-based directly observed anti-tuberculosis treatment in Mongolia. In: International Journal of Tuberculosis and Lung Disease. 2015 ; Vol. 19, No. 6. pp. 657-662.
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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 drugresistant 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. RESULT S : 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 DOTimproved 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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Dobler, CC, Korver, S, Batbayar, O, Oyuntsetseg, S, Tsolmon, B, Wright, C, Solongo, B & Marais, BJ 2015, 'Success of community-based directly observed anti-tuberculosis treatment in Mongolia' International Journal of Tuberculosis and Lung Disease, vol. 19, no. 6, pp. 657-662. https://doi.org/10.5588/ijtld.14.0927

Success of community-based directly observed anti-tuberculosis treatment in Mongolia. / Dobler, C. C.; Korver, S.; Batbayar, O.; Oyuntsetseg, S.; Tsolmon, B.; Wright, C.; Solongo, B.; Marais, B. J.

In: International Journal of Tuberculosis and Lung Disease, Vol. 19, No. 6, 01.06.2015, p. 657-662.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Dobler, C. C.

AU - Korver, S.

AU - Batbayar, O.

AU - Oyuntsetseg, S.

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AU - Wright, C.

AU - Solongo, B.

AU - Marais, B. J.

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N2 - 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 drugresistant 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. RESULT S : 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 DOTimproved 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.

AB - 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 drugresistant 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. RESULT S : 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 DOTimproved 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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