Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city

Abstract

Objective: To assess the degree of implementation of the Directly Observed Treatment, Short-course -DOTS for tuberculosis (TB) in a large city. Method: Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. Results: The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. Conclusion: The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program. descriPtOrs Tuberculosis; Directly Observed Therapy; Health Evaluation; Program Evaluation; Public Health Nursing.Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city Avaliação da implantação da estratégia de tratamento diretamente observado para tuberculose em um município de grande porte Evaluación de la implantación de la estrategia de tratamiento directamente observado para tuberculosis en un municipio de gran porte Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city

Implementation fidelity of hospital based directly observed therapy for tuberculosis treatment in Bhutan: mixed-method study

“…DOT was provided more to SPPT (83.3%) and MDR-TB (100%) compared to SNPT (20%) and EPT (28.2%). Similar results were found in other countries like in Brazil [15][16][17], Ethiopia [18] Indonesia [19], and India [14]. A study by Lavor et al [15], found that DOTS was partially implemented in Brazil [15].…”

Detecção da tuberculose: a estrutura da atenção primária à saúde

“…In Pelotas the lack of training courses was unanimously pointed out, and the communication between TB coordination and PHC teams was described as purely bureaucratic, related to exam results and material requirements. For the early detection of SRs to be possible, all professionals in the PHC team must be prepared and aware, so they can raise immediate suspicion for TB cases when respiratory symptoms are present, which is only possible if they are made aware, not only in the form of goals to meet a certain number of detected cases, but also in the offer of theoretical-scientific subsidies, continued training, disease control and epidemiological importance (20) .…”

Coordination of health care with the community in the clinical management of tuberculosis

“…Another research showed that the weakness in political coordination, developed through local health councils, can influence the implementation of the Directly Observed Treatment (DOT). Consequently, it is not possible to establish partnerships with health professionals for the construction of strategies directed to the needs in this context (15) .…”