Abstract

This study includes the treatment outcomes of tuberculosis patients of our TB dispensary under directly observed treatment (DOT) for 3 years between April 1st, 2000 and March 31st, 2003. We treated 230 cases out of 254 registered TB patients (91%) under direct observation. DOT could not be given in 18 cases in the first year, and in 3 cases in each of the following 2 years. Cases treated with DOT were mostly male (76%), and their ages were mostly between 35-44 or above 65. Of the patients, 90% were new cases, and 77% had pulmonary tuberculosis. Smear positivity was 52% (120/230) in all cases and 67% (120/178) in pulmonary tuberculosis cases. Culture proven cases were 79% among pulmonary TB patients. Cases treated under DOT in three consecutive years were as follows, respectively: TB dispensary group 33%, 35% and 37%; primary health care units group 15%, 21%, 41%; other institutions group 1%, 13% and 14%; and family members group 51%, 30% and 9%. Our cure rate with DOT was 90.8%, treatment success was 95.7%. Treatment failure was documented in two cases (0.8%) and 8 cases (3.5%) died during treatment. None of the patients defaulted in three years period. Relapse was observed in two cases treated by family members, 12 and 15 months after completing therapy (0.8%). During this period, the percentage of our patients receiving DOT increased, the number of patients treated by family observation decreased and the number of patients treated in primary health care units increased. Implementation of DOT requires a lot of work, but it is necessary and possible to implement it permanently.