Decentralising DOT for drug-susceptible TB from the health facilities to the community level in Togo-Reference-Cited by-同舟云学术

Decentralising DOT for drug-susceptible TB from the health facilities to the community level in Togo

Published:2024-04-01 Issue:4 Volume:28 Page:195-201
ISSN:1027-3719
Container-title:The International Journal of Tuberculosis and Lung Disease
language:en
Short-container-title:int j tuberc lung dis

Author:

Dogo F.M.¹,Ate S.²,Agossou K.²,Menon S.³,Fiogbé A.A.⁴,Akpadja K.²,Adjoh S.K.⁵,Veronese V.⁶,Merle C.S.⁶,Koura K.G.⁷

Affiliation:

1. National Tuberculosis Programme, Lomé, Togo;, International Union Against Tuberculosis and Lung Disease, Paris, France;

2. National Tuberculosis Programme, Lomé, Togo;

3. International Union Against Tuberculosis and Lung Disease, Paris, France;

4. International Union Against Tuberculosis and Lung Disease, Paris, France;, National Tuberculosis Programme, Cotonou, Service de Pneumologie, Centre National et Universitaire de Pneumo-Phitsiologie de Cotonou (CNHUPP/C), Cotonou, Benin;

5. Service de Pneumologie- Phitsiologie, Centre Hospitalier et Universitaire Sylvanus Olympio de Lomé, Lomé, Togo;

6. The Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland;

7. International Union Against Tuberculosis and Lung Disease, Paris, France;, COMUE (Communautés d’Universités et Établissements) Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Paris Descartes University, Paris, France

Abstract

<sec id="st1"><title>BACKGROUND</title>In Togo, the COVID-19 pandemic paved the way for decentralising directly observed treatment (DOT) to the community level through the evaluation of two innovative community-based DOT approaches—a community health worker-based (CHW-DOT) and family-based (FB-DOT).</sec><sec id="st2"><title>METHODS</title>We conducted an observational prospective study from April 2021 to January 2022. Sputum conversion at Month 2 and favourable treatment outcomes at Month 6 were assessed and compared between the two groups. Sociodemographic and clinical factors related to these outcomes were identified.</sec><sec id="st3"><title>RESULTS</title>A total of 182 TB patients were enrolled. The CHW-DOT group had significantly increased odds of sputum conversion (aOR 2.95, 95% CI 1.09–7.98) and lower odds of unsuccessful treatment outcomes (aOR 0.37, 95% CI 0.13–1.1). Non-smokers had 4.85 higher odds of converting than smokers (aOR 4.85, 95% CI 1.76–13.42) and lower odds of an unsuccessful treatment than smokers (aOR 0.11, 95% CI 0.04–0.32).</sec><sec id="st4"><title>CONCLUSION</title>CHW-DOT is associated with higher sputum smear conversion rates and a more favourable treatment outcome. The use of tobacco, significantly associated with outcomes, also suggests that a smoking cessation component may be a valuable adjunct to a CHW-DOT approach during TB treatment.</sec>

Publisher

International Union Against Tuberculosis and Lung Disease