Skip to main content
  • Original article
  • Open access
  • Published:

Assessment of directly observed therapy short-course (DOTs) of tuberculosis in Dakahlia governorate chest hospitals from 2006 to 2011

Abstract

Aim

The aim of the study was to assess directly observed therapy short-course administered to diagnosed cases of tuberculosis (TB) in the period from 2006 to 2011 in Dakahlia chest hospitals as a tool for the treatment and control of TB in the community.

Materials and methods

Comprehensive collection of data was carried out of all TB cases registered in the Dakahlia governorate (six hospitals) from 2006 to 2011.

Results

TB was most commonly prevalent in the age group 15–29 years (32.3%). TB was common in male (65.6%) than female (34.4%), and common in rural areas (90%); in urban areas, the prevalence was 10%. Pulmonary cases (66.9%) were more prevalent than extrapulmonary cases (33.1%). There was a significant reduction in pulmonary cases from 69.2% in 2006 to 56.5% in 2011 and there was a significant increase in extrapulmonary cases from 30.8% in 2006 to 43.5% in 2011. The most common site of TB was sputum smear-positive pulmonary TB (74.2%) and sputum smearnegative pulmonary TB (25.8%). The most common site of extrapulmonary TB was pleural TB (50.9%) and tuberculous lymphadenitis (19.6%). New cases (88.8%) represented the highest percentage of all cases attending for treatment. Sputum conversion was 53, 51.5, and 75.9% at 2, 5 months, and at the end of treatment, respectively. In all, 84.8% of cases were treated successfully (23.1% cured cases and 61.7% cases that completed treatment; almost achieving the WHO target of 85%). In all, 5.1% of cases failed treatment, 5.1% died, 2.4% were defaulters, and 2.6% of cases were transferred out.

Conclusion

The introduction of directly observed therapy short-course in Dakahlia governorate chest hospitals has led to a significant increase in treatment success (84.8%) and a decrease in default and failure rates.

References

  1. WHO. GGlobal tuberculosis control: surveillance, planning, financing, WHO report, Geneva, (WHO/HTM/TB/2011.16) accessed September 2011.

  2. Leão SC, Portaels, F. History. In: Palomino JC, Leão SC, Ritacco V, editors. Tuberculosis 2007: From basic science to patient care. Belgium, Brazil, Argentina: Flying Publisher; 2007.

    Google Scholar 

  3. Ministry of Health and Population. National Tuberculosis Control Program (NTP). Egypt: Ministry of Health and Population; 2010.

  4. Marinker M, Shaw J. Not to be taken as directed. Putting concordance for taking medicines into practice. BMJ 2003; 326:348–349.

    Article  Google Scholar 

  5. National Tuberculosis Control Program. National tuberculosis control program, manual of tuberculosis control in Egypt. Egypt: Ministry of Health and Population; 2006.

  6. WHO. Global tuberculosis control: surveillance, planning, financing, WHO report (WHO/HTM/TB/2004.331). Geneva: WHO; 2004.

  7. Knapp RG, Miller MC. Clinical epidemiology and biostatistics (National Medical Series for Independent Study). Baltimore, United States: Williams & Wilkins Imprint Harwell Publishing Company; 1992. pp. 1–435.

  8. Hindi MR. Assessment of directly observed therapy short course (DOTS) of tuberculosis in Benha Chest Hospital [Master Degree thesis]. Benha: Benha University; 2009.

  9. Abdelghany AE. Tuberculosis situation in Menoufia governorate (19922008) before and after direct observed therapy short course strategy (DOTS) [Master Degree thesis]. Benha: Benha Faculty of Medicine; 2010.

  10. Shargie EB, Lindtjorn B. DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: a retrospective trend analysis. BMC Public Health 2005; 5:62.

    Article  Google Scholar 

  11. Long R, Njoo H, Hershfield E. Epidemiology of tuberculosis disease in Canada. Can Med Assoc J 1999; 160:1185–1190.

    CAS  Google Scholar 

  12. Fitzgerald DW, Sterling R, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, Mandelle D, Douglas S, editors. Bennett’s principles and practice of infectious disease. 8th ed. New York: Churchill Livingstone; 2000. pp. 2787–2819.

  13. Al-Aarag HA. Morbidity and mortality from pulmonary tuberculosis in Benha region [Master Degree thesis]. Zagazig: Benha Faculty of Medicine, Zagazig University; 1983.

  14. Suhadev M, Swaminathan S, Rajasekaran S, Thomas BE, Arunkumar N, Muniyandi Mand Meenoladhani D. Feasibility of community DOT providers for tuberculosis treatment in HIV infected individuals − a pilot study. Indian J Tuberc 2005; 52:179–183.

    Google Scholar 

  15. Anuwatnonthakate A, Limsomboon P, Nateniyom S, Wattanaamornkiat W, Komsakorn S, Moolphate S, et al. Directly observed therapy and improved tuberculosis treatment outcomes in Thailand. PloS One 2008; 3:e3089.

  16. Raviglione MC, Snider DE, Kochi A. Global epidemiology of tuberculosis. Morbidity and mortality of a worldwide epidemic. JAMA 1995; 273:220–226.

    Article  CAS  Google Scholar 

  17. Te Beek LAM, van der Werf MJ, Richter C, Borgdorff MW. Extrapulmonary tuberculosis by Nationality, in the Netherlands, 1993–2001. Emerg Infect Dis 2006; 12:1375–1382.

    Article  Google Scholar 

  18. Musellin B, Erturan S, SonmezDuman E, Ongen G. Comparison of extrapulmonary and pulmonary cases: factors influencing the site of reactivation. Int J Tuberc Lung Dis 2005; 9:1220–1223.

    Google Scholar 

  19. Rieder HL, Snider DE, Cauthen JR. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis 1990; 141:347–351.

    Article  CAS  Google Scholar 

  20. Hopewell PC. Overview of clinical tuberculosis. In: Bloom B, editor. Tuberculosis: pathogenesis, protection, and control. 2nd ed. Washington, DC: American Society for Microbiology; 1994. pp. 25–46.

  21. Kumaresan JA, Ahsan Ali AK, Parkkali LM. Tuberculosis control in Bangladesh: success of the DOTS strategy. Int J Tuberc Lung Dis 1998; 2:992–998.

    CAS  PubMed  Google Scholar 

  22. Volmink J, Garner P. Directly observed therapy for treating tuberculosis. Cocharane Database Syst Rev 2003; 1:CD003343.

    Google Scholar 

  23. Mohan A, Nassir H, Niazi A. Does routine home visiting improve the return rate and outcome of DOTS patients who delay treatment? East Mediter Health J 2003; 9:702–708.

    CAS  Google Scholar 

  24. Tolba Tolba F, El-Ebiary S, Mokhtar A, Maseh OA, Decoster E. Tuberculosis control programme; Ministry of Health and Population, Egypt; Institutional factors contributing to TB patients defaulting: a provider perspective. Egypt: National Tuberculosis Control Program; 1995.

  25. Tahir M, Sharma SK, Rohrberg DS, Gupta D, Singh UB, Sinha PK. DOTS at a tertiary care centre in a northern India: success, challenges and the next steps in tuberculosis control. Indian J Med Res 2006; 123:702–706.

    PubMed  Google Scholar 

  26. Bao Q-S, Du Y-H, Lu C-Y. Treatment outcome of new pulmonary tuberculosis in Guangzhou, China 1993–2000: a register-based cohort study. BMC Public Health 2007; 7:344.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amira H. Allam MD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Negm, M.F., Allam, A.H. & El Zeheiry, F.S. Assessment of directly observed therapy short-course (DOTs) of tuberculosis in Dakahlia governorate chest hospitals from 2006 to 2011. Egypt J Bronchol 11, 88–97 (2017). https://doi.org/10.4103/ejb.ejb_55_16

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejb.ejb_55_16

Keywords