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
. 2012;7(3):270-84.
doi: 10.1080/17441692.2011.552067. Epub 2011 Jun 1.

Task shifting for tuberculosis control: a qualitative study of community-based directly observed therapy in urban Uganda

David K Mafigiri  1 , Janet W McGrath, Christopher C Whalen
Affiliations

Task shifting for tuberculosis control: a qualitative study of community-based directly observed therapy in urban Uganda

David K Mafigiri et al. Glob Public Health. 2012.

Abstract

This qualitative study of task shifting examined tuberculosis (TB) therapy under modified community-based directly observed treatment short-course (CB-DOTS) in Kampala, Uganda. New TB patients selected one of two strategies: home-based DOTS and clinic-based DOTS. Relevant socio-economic characteristics, treatment-seeking experiences and outcomes were assessed over eight months of follow-up. Of 107 patients recruited, 89 (83%) selected home-based DOTS. Sixty-two patients (70%) under home-based DOTS and 16 patients (89%) under clinic-based DOTS had successful outcomes following completion of tuberculosis therapy. Treatment supporters' provision of social support beyond observing drug ingestion contributed to successful outcomes under both strategies. Home-based DOTS provides continuity of social support during therapy, strengthening the potential for treatment success. Conventional health facility-based DOTS can be modified in resource-limited urban Africa to offer a viable DOTS strategy that is sensitive to personal preference. Shifting the task of DOTS support away from only qualified health workers to include laypersons in the patients' social-support network may contribute to meeting World Health Organization (WHO) treatment targets. We recommend an intervention evaluating this modified DOTS strategy on a larger scale in TB high-burden, resource-poor urban settings.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow of participants through the study
See this image and copyright information in PMC

References

    1. Adatu F, Odeke R, Mugenyi M, Gargioni G, McCray E, Schneider E, Maher D. Implementation of the DOTS strategy for tuberculosis control in rural Kiboga District, Uganda, offering patients the option of treatment supervision in the community, 1998–1999. The International Journal of Tuberculosis and Lung Disease. 2003;7:S63–S71. - PubMed
    1. Cavalcante SC, Soares EC, Pacheco AG, Chaisson RE, Durovni B. Community DOT for tuberculosis in a Brazilian favela: Comparison with a clinic model. The International Journal of Tuberculosis and Lung Disease. 2007;11:544–549. - PubMed
    1. Chowdhury AM, Chowdhury S, Islam MN, Islam A, Vaughan JP. Control of tuberculosis by community health workers in Bangladesh. Lancet. 1997;350:169–172. - PubMed
    1. Clarke M, Dick J, Zwarenstein M, Lombard CJ, Diwan VK. Lay health worker intervention with choice of DOT superior to standard TB care for farm dwellers in South Africa: A cluster randomised control trial. The International Journal of Tuberculosis and Lung Disease. 2005;9:673–679. - PubMed
    1. Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC. Consensus statement. Global burden of tuberculosis: Estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. Journal of American Medical Association. 1999;282:677–686. - PubMed

Publication types

Substances