Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Feb;14(2):203-9.

Community-randomized trial of enhanced DOTS for tuberculosis control in Rio de Janeiro, Brazil

S C Cavalcante  1 , B Durovni, G L Barnes, F B A Souza, R F Silva, P F Barroso, C I Mohan, A Miller, J E Golub, R E Chaisson
Affiliations
Randomized Controlled Trial

Community-randomized trial of enhanced DOTS for tuberculosis control in Rio de Janeiro, Brazil

S C Cavalcante et al. Int J Tuberc Lung Dis. 2010 Feb.

Abstract

Setting: Central Rio de Janeiro, Brazil.

Objective: To compare the impact of routine DOTS vs. enhanced DOTS (DOTS-Ampliado or DOTS-A) on tuberculosis (TB) incidence.

Design: Cluster-randomized trial in eight urban neighborhoods pair-matched by TB incidence and randomly assigned to receive either the DOTS-A or DOTS strategy. DOTS-A added intensive screening of household contacts of active TB cases and provision of treatment to secondary cases and preventive therapy to contacts with latent TB infection (LTBI) to the standard DOTS strategy. The primary endpoint was the TB incidence rates in communities after 5 years of intervention.

Results: From November 2000 to December 2004, respectively 339 and 311 pulmonary TB cases were enrolled and 1003 and 960 household were identified in DOTS and DOTS-A communities. Among contacts from DOTS-A communities, 26 (4%) had active TB diagnosed and treated, 429 (61.3%) had LTBI detected and 258 (60.1%) started preventive therapy. TB incidence increased by 5% in DOTS communities and decreased by 10% in DOTS-A communities, for a difference of 15% after 5 years (P = 0.04).

Conclusion: DOTS-A was associated with a modest reduction in TB incidence and may be an important strategy for reducing the burden of TB.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Outcome of contact investigation. TB = tuberculosis; LTBI = latent TB infection; TST = tuberculin skin test.
Figure 2
Figure 2
Tuberculosis incidence in DOTS and DOTS-A communities. TB = tuberculosis; DOTS-A = DOTS ampliado (enhanced DOTS).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Enarson D, Rieder H, Arnadottir T, Trébucq A. A guide for low income countries. 5. Paris, France: International Union Against Tuberculosis and Lung Disease; 2000. Management of tuberculosis.
    1. World Health Organization. WHO report 1994. Geneva, Switzerland: WHO; 1994. [Accessed November 2009]. Framework for effective tuberculosis control. WHO/TB/94.179. http://whqlibdoc.who.int/hq/1994/WHO_TB_94.179.pdf.
    1. De Cock KM, Chaisson RE. Will DOTS do it? A reappraisal of tuberculosis control in countries with high rates of HIV infection. Int J Tuberc Lung Dis. 1999;3:457–464. - PubMed
    1. Kenyon TA, Mwasekaga MJ, Huebner R, et al. Low levels of drug resistance amidst rapidly increasing tuberculosis and human immunodeficiency virus co-epidemics in Botswana. Int J Tuberc Lung Dis. 1999;3:4–11. - PubMed
    1. Morrison J, Pai M, Hopewell PC. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2008;8:359–368. - PubMed

Publication types

Substances