The 130th Annual Meeting of APHA

Abstract #37810

Thomas Nicholson, PhD¹, Baishali Bhattacharya, MD², John B. White, PhD¹, Wayne Higgins, PhD¹, and S. Patricia Minors, PhD, MBA¹. (1) Public Health, Western Kentucky University, Western Kentucky University, One Big Red Way, Bowling Green, KY 42101-3576, 270/745-5855, thomas.nicholson@wku.edu, (2) Dept. of Pathology, Rush-Presbyterian St. Luke's medical Center, Rush University, 7 Van Buren, Apt. 7, Oak Park, IL 60304

Tuberculosis is the leading cause of infectious disease in Nepal. An estimated 60% of the adult population aged between 15-45 years are infected with tuberculosis and 45% of the total population are infected. To combat tuberculosis, Directly Observed Therapy (DOT) was adopted in Nepal in 1996. DOT was administered at four national demonstration sites in 1996 and expanded over time so that 56% of the population to date have been covered by DOT. This study aimed to evaluate DOT in pulmonary TB patients in Nepal in terms of patient outcome and compliance. The project was a retrospective non-concurrant cohort study. Patients were sputum positive pulmonary TB patients aged over 15 years from Bhaktapur district in Nepal, who had undergone DOT or SAT between 1996 and 1998. Medical records of all the patients was sent to National TB Center in Thimi, Nepal. A total of 261 patients, (DOT, 161 patients and SAT, 100 patients) were included in the study. The two groups were comparable in terms of age, ethnicity, and religion distribution. The cure rate was 86.3% for DOT and 75% for SAT group (p<0.05). The compliance rate was 90.2% for DOT versus 81.8% for SAT group (p<0.05). The mean treatment length was 6.8 months for the SAT group and 7.4 months for the DOT group (p<0.05). Higher rates of treatment compliance and cure rate was achieved in the DOT group versus the SAT group. Thus, DOT is advocated as a means of ensuring greater success.

Learning Objectives:

• Understand the epidemology of Tuberculosis in less developed countries (Nepal);
• Evaluate the efficacy of Directly Observed Therapy (DOT) verses self-administered therapy;
• Articulate global DOT efforts.

Keywords: TB, International Public Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.