Direct observation and adherence to tuberculosis treatment in Chongqing, China: a descriptive study

Abstract

In China, direct observation is not well implemented and may not be a feasible policy option. Official completion rates are higher than we found in this study. The concept of free treatment has become blurred, with charges for additional tests and drugs, especially liver protection drugs. The government is already actively tackling these issues, and involvement of managers and others in this process will be helpful.

Preventive use of a hepatoprotectant against anti‐tuberculosis drug‐induced liver injury: A randomized controlled trial

“…10 The overprescription of hepatoprotectants adds a further financial burden to patients, as these drugs are not included in the China government's "free TB service policy." 11,12 The rationale behind the use of hepatoprotectants should receive much more attention. 13 This study aims to evaluate the effects of the preventive use of the hepatoprotectant Silybum marianum against drug-induced liver injury among tuberculosis patients and to provide clinical guidelines and policy recommendation for tuberculosis management in China.…”

Evaluating the policy of setting up microscopy centres at township hospitals in Shandong China: Experience from patients and providers

“…Chinese farmers report high TB diagnosis and treatment costs [3][4][5]. In China's poor and remote areas, travelling to the county TB dispensary (CTD), which may account for 2-20% of overall costs related to TB, was reported as a major barrier [6][7][8][9][10][11].…”

Why financial incentives did not reach the poor tuberculosis patients? A qualitative study of a Fidelis funded project in Shanxi, China

“…Studies reported less than 10% of rural TB patients were actually observed by village doctors in Chongqing and Shandong provinces [18,26]. A number of reasons were highlighted here: (1) it was not convenient for patients and village doctors to meet each other on a daily basis; (2) patients were afraid that their TB status might be revealed by meeting often with a village doctor; and (3) village doctors were private practitioners who relied on patient user fees to make a living.…”

“…A number of reasons were highlighted here: (1) it was not convenient for patients and village doctors to meet each other on a daily basis; (2) patients were afraid that their TB status might be revealed by meeting often with a village doctor; and (3) village doctors were private practitioners who relied on patient user fees to make a living. Village doctors were not interested in earning such a small amount for supervising a TB patient over the six months course of TB treatment [16,19,26]. Therefore, providing the supervision incentive to village doctors had very little effect on improving TB treatment.…”