AI Article Synopsis
- The study compares the effectiveness of community-based (CB) directly observed therapy (DOT) to traditional clinic DOT for treating tuberculosis (TB).
- CB DOT, facilitated by community health workers or volunteers, showed a significantly higher treatment success rate than clinic DOT, with a pooled odds ratio of 1.54.
- However, the difference in loss to follow-up rates was not statistically significant, and findings should be viewed cautiously since only one of the eight studies analyzed was randomized.
Article Abstract
Background: Directly observed therapy (DOT), as recommended by the World Health Organization, is used in many countries to deliver tuberculosis (TB) treatment. The effectiveness of community-based (CB DOT) versus clinic DOT has not been adequately assessed to date. We compared TB treatment outcomes of CB DOT (delivered by community health workers or community volunteers), with those achieved through conventional clinic DOT.
Methods: We performed a systematic review and meta-analysis of studies before 9 July 2014 comparing treatment outcomes of CB DOT and clinic DOT. The primary outcome was treatment success; the secondary outcome was loss to follow-up.
Results: Eight studies were included comparing CB DOT to clinic DOT, one a randomised controlled trial. CB DOT outperformed clinic DOT treatment success (pooled odds ratio (OR) of 1.54, 95% confidence interval (CI) 1.01 - 2.36, p = 0.046, I(2) heterogeneity 84%). No statistically significant difference was found between the two DOT modalities for loss to follow-up (pooled OR 0.86, 95% CI 0.48 to 1.55, p = 0.62, I(2) 83%).
Conclusions: Based on this systematic review, CB DOT has a higher treatment success compared to clinic DOT. However, as only one study was a randomised controlled trial, the findings have to be interpreted with caution.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436810 | PMC |
| http://dx.doi.org/10.1186/s12879-015-0945-5 | DOI Listing |
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