12-Year Treatment Outcomes of Tuberculosis Patients: A Full-Scale Non-Family DOT Model in Thailand

Phanchai RATTANASUWAN, Chonlada YUANLAE, Pakawan DAEWA, Kamonwan IMDUANG


A descriptive study of a non-family DOT (Directly-Observed Treatment) model in the Muang District of Nakhon Si Thammarat Province in Thailand was conducted, with the aim of reviewing the 12-year treatment outcomes under the full-scale non-family DOT model, in order to demonstrate the possibility and feasibility of DOT in Thailand. Four hundred and fifty four new smear-positive pulmonary TB patients, registered during the fiscal year 2001 - 2012, were evaluated for treatment outcomes. The overall cure rate and treatment success were 81.1 and 84.0 %, respectively. The proportion of the TB patients under the model that received DOT by health staff was as high as 95.0 %, even in the urban setting. We have concluded that a non-family DOT service for new smear-positive TB patients is possible and feasible in Thailand, even in an urban setting.



Tuberculosis, TB, DOT, non-family, DOTS

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World Health Organization. Global Tuberculosis Report 2013. WHO/HTM/TB/2013.11, France, 2013.

Y Kasetjaroen, P Pungrassami, P Maneesang, P Hassapark, V Tunsawai and D Tonghaem. Directly Observed Therapy (DOT) of pulmonary tuberculosis: roles of family members. Thai J. Tuberc. Chest. Dis. (in Thai) 1995; 16, 237-49.

World Health Organization and Ministry of Public Health of Thailand. Tuberculosis Programme Review. Thailand, 1995.

S Akkslip, S Rasmithat, D Maher and H Sawert. Direct observation of tuberculosis treatment by supervised family members in Yasothorn province, Thailand. Int. J. Tuberc. Lung Dis. 1999; 3, 1061-5.

P Kamolratanakul, H Sawert, S Lertmaharit, Y Kasetjaroen, S Akksilp, C Tulaporn, K Punnachest, S Na-Songkhla and V Payanandana. Randomized controlled trial of directly observed treatment (DOT) for patients with pulmonary tuberculosis in Thailand. Trans. R. Soc. Trop. Med. Hyg. 1999; 93, 552-7.

Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Thailand. Annual Epidemiological Surveillance Report 2011 (in Thai). Bangkok, 2011.

Centers for Disease Control and Prevention, National Center for Prevention Services, Division of Tuberculosis Elimination, United States of America. Improving Patient Adherence to Tuberculosis Treatment, Revised 1994. Atlanta, CDC, 1994.

World Health Organization. Tuberculosis Handbook.WHO/TB/98.253, Italy, 1998.

P Rattanasuwan, C Yuanlae and P Daewa. DOT (Directly-Observed Treatment) by assigning other persons who were not family members: A model of 11th Zonal Tuberculosis Center, Nakhon Si Thammarat in the fiscal year 1999 - 2000 (in Thai). Songkla. Med. J. 2002; 20, 69-78.

P Rattanasuwan. The study on the “REFER” referral system of the new smear-positive TB patients from 11th Zonal TB Center to the community hospitals in Nakhon Si Thammarat (in Thai). Thai J. Tuberc. Chest. Dis. 2000; 21, 183-94.

V Payanandana, B Kladphuang, W Somsong and S Jittimanee. Battle Against TB: National Tuberculosis Programme, Thailand. Bangkok, Thailand, 1999.

P Rattanasuwan. Epidemiology and Tuberculosis (in Thai). Medsai Printing Company, Nakhon Si Thammarat, Thailand, 2008.

National Health Security Office. National Health Security Acts B.E. 2545 (A.D. 2002). 2002.

World Health Organization. Guidelines for Establishing DOTS-Plus Pilot Projects for the Management of Multidrug-Resistant Tuberculosis (MDR-TB). WHO/CDS/TB/2000.279, Italy, 2000.

World Health Organization. Interim Policy on Collaborative TB/HIV Activities. WHO/HTM/TB/2004.330. Geneva, Switzerland, WHO, 2004.

P Rattanasuwan. Why do we need to treat TB patients with DOT? (in Thai). Thai J. Tuberc. Chest. Dis. 2001; 22, 195-8.

P Rattanasuwan. Principle of Tuberculosis Control: a Ten-Year Experience (in Thai). Medsai Printing Company, Nakhon Si Thammarat, Thailand, 2003.

World Health Organization, Regional Office for South-East Asia. Regional Strategic Plan on HIV/TB. 2003.

World Health Organization. Treatment of Tuberculosis: Guidelines for National Programmes. 3rd ed. WHO/CDS/TB/2003.313, Italy, 2003.

P Rattanasuwan. Tuberculosis Treatment: Guidelines for Thai Health Center Staff (in Thai). Medsai Printing Company, Nakhon Si Thammarat, Thailand, 2007.


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