Evaluation of a Directly Observed Therapy Short-Course Project for Treating Tuberculosis on Offshore Island Kinmen County

Chiu-Hsia Su ； Ming-Chih Yu ； Shih-Yan Yang ； Ya-Jung Hu ； Yung-Ming Chang

《Epidemiology Bulletin》 23卷2期 (2007/02) Pp. 29-46

https://doi.org/10.6525/TEB.200702_23(2).0001

並列摘要

Tuberculosis (TB) came first in both the incidence and death rates amongst all notifiable infectious diseases in Taiwan. In order to improve the situation, Taiwan CDC implemented a Directly Observed Therapy Short-course (DOTS) project in Kinmen County for the first time from July 2004 to December 2005, which will later serve as a reference in establishment of a full-scale DOTS program covering the entire Taiwan area in 2006.
Patients who either had a positive sputum smear or poor compliance to medications were enrolled in the DOTS project after counseling. Original information of the target cases was obtained from the TB database of the CDC, and all treatment outcomes in the project were classified into three categories: cured, dropped outs, and died.
Between July 2004 and December 2005, there were 23 TB cases reported in Kinmen County and filed into the CDC TB database, of which 20 cases (12 cases being sputum smear positive) were male and 3 cases (all sputum smear-positive) female. Their average age was 63.2 years old. After counseling, 12 cases agreed to participate in the project, which represented a coverage rate of 52.2%. Out of the 12 cases, 11 were males (10 smear positive) and one female (one smear positive), and the average age of the group was 61.7 years old. Among the individuals who were enrolled in this DOTS project, it was 83.3% in the cured category at the end of the project with no dropped outs. In comparison, the rate of the cured category was only 45.5% for those individuals who did not sign up in the project, and the dropped out rate was 9.1%.
The outcomes from this pilot project indicated that the implementation of DOTS has significant beneficial effects on the case management of TB. According to the strategy formulated and recommended by the World Health Organization, active promotion of DOTS strategy is so far the most effective way to fight against TB. Therefore, it is very encouraging for us to continue our efforts in implementing the DOTS into the management of TB cases in Taiwan.