To address the vexing problem of treatment completion for tuberculosis patients, the Baltimore City Health Department (BCHD) in 1981 implemented a community outreach strategy employing directly observed therapy (DOT).
By 1995, the incidence of tuberculosis in Baltimore had declined 61.7%. This BCHD program has reduced the need for patient incentives by providing nearly 90% of all DOT at either the patient's home, workplace or school ; or drug treatment facility, city jail, or nursing home.
Today, the proportion of all TB cases in Baltimore receiving DOT through the program approaches 90%, treatment completion rates exceed 90%, sputum-conversion rates among DOT-managed cases are nearly double the rates of privately treated cases, and drug resistant organisms remain rare (0.57% of all isolates, 1989-1993).
This article describes the interworkings of this community-based program.
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Mycobacterium tuberculosis, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bactérie, Antituberculeux, Programme, Surveillance, Homme, Antibiotique, Chimiothérapie, Traitement, Baltimore
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Mycobacterium tuberculosis, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bacteria, Antituberculous agent, Program, Surveillance, Human, Antibiotic, Chemotherapy, Treatment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0315744
Code Inist : 002B02S02. Création : 12/09/1997.