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Therapeutics
Direct observation of tuberculosis treatment did not promote higher cure rates than self administered treatment

https://doi.org/10.1136/ebm.6.5.142

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    (2001) Lancet 357, 664. Walley JD, Khan MA, Newell JN, et al. . Effectiveness of the direct observation component of DOTS for tuberculosis: a randomised controlled trial in Pakistan.. Mar 3;. :. –9..
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 QUESTION: In Pakistani patients with tuberculosis, what is the effectiveness of the directly observed treatment, short-course (DOTS) strategy by a health worker or family member?

    Design

    8 month randomised {allocation concealed*}†, blinded (clinicians and outcome assessors),* controlled trial.

    Setting

    3 tuberculosis treatment centres in Pakistan.

    Patients

    497 patients who were ≥15 years of age (42% were 15 to 24 y, 22% were 25 to 34 y; 51% men) and were newly diagnosed with sputum-positive pulmonary tuberculosis, had not previously received tuberculosis treatment, and lived in the catchment area. Follow up was complete.

    Intervention

    Patients were allocated to 1 of 3 treatments: self administered treatment, in which patients received tuberculosis drugs every 2 weeks from the closest health facility (n=162); health worker DOTS, involving a 2 month intensive phase during which a health …

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    Footnotes

    • Source of funding: Department for International Development, UK.

    • For correspondence: Dr J D Walley, Nuffield Institute for Health, University of Leeds, Leeds LS2 9PL, England, UK. Fax +44 (0)113 246 0899.

    • ↵* See glossary.

    • ↵† Information provided by author.