Background
Multidrug-resistant
tuberculosis (MDR-TB) represents a major obstacle towards successful TB
control. Directly observed therapy (DOT) was recommended by WHO to improve
adherence and treatment outcomes of MDR-TB patients, however, the effectiveness
of DOT on treatment outcomes of MDR-TB patients was mixed in previous studies.
We conducted this systematic review and meta-analysis to assess the association
between DOT and treatment outcomes and to examine the impact of different DOT
providers and DOT locations on successful treatment outcomes in MDR-TB
patients.
Methods
We searched studies
published in English between January 1970 and December 2015 in major electronic
databases. Two reviewers independently screened articles and extracted
information of DOT, treatment success rate and other characteristics of
studies. Random effects model was used to calculate the pooled treatment
success rate and 95% confidence interval (CI). Sub-group analyses were
conducted to access factors associated with successful treatment outcomes.
Results
A total of 31 articles
7,466 participants were included. Studies reporting full DOT (67.4%, 95% CI:
61.4–72.8%) had significantly higher pooled treatment success rates than those
reporting self-administration therapy (46.9%, 95% CI: 41.4–52.4%). No statistically
difference was found among DOT provided by healthcare providers (65.8%, 95% CI:
55.7–74.7%), family members (72.0%, 95% CI: 31.5–93.5%) and private DOT
providers (69.5%, 95% CI: 57.0–79.7%); and neither did we find significantly
difference on pooled treatment success rates between patients having health
facility based DOT (70.5%, 95% CI: 61.5–78.1%) and home-based DOT (68.4%, 95%
CI: 51.5–81.5%).
Conclusion
Providing DOT for a full
course of treatment associated with a higher treatment success rate in MDR-TB
patients.
Full article at: http://goo.gl/X32DpW
By: Jia Yin,1 Jinqiu Yuan,1 Yanhong Hu,1 and Xiaolin Wei1,2,*
1The Jockey Club School of Public Health
and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
2Dalla Lana School of Public Health,
University of Toronto, Toronto, Ontario, Canada
Fundació Institut
d’Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat
Autònoma de Barcelona, SPAIN
More at: https://twitter.com/hiv insight
No comments:
Post a Comment