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
Multicenter Study
. 2017 Aug 1;12(8):e0181205.
doi: 10.1371/journal.pone.0181205. eCollection 2017.

Is directly observed tuberculosis treatment strategy patient-centered? A mixed method study in Addis Ababa, Ethiopia

Belete Getahun  1   2 , Zethu Zerish Nkosi  1
Affiliations
Multicenter Study

Is directly observed tuberculosis treatment strategy patient-centered? A mixed method study in Addis Ababa, Ethiopia

Belete Getahun et al. PLoS One. .

Abstract

Introduction: The directly observed treatment, short course (DOTS) strategy has been considered as an efficacious approach for better tuberculosis (TB) treatment adherence and outcome. However, its level of patient centerdness has not been studied and documented well. Hence, the study aimed to determine the level of patient centeredness' of the DOTS.

Method: The study used explanatory sequential mixed method design in Addis Ababa, Ethiopia. The study employed an interviewer-administered questionnaire with 601 patients with TB, focus group discussions with 23 TB experts, and telephonic-interview with 25 persons lost to follow-up from TB treatment. Descriptive and multivariable analyses carried out for the quantitative data while thematic analysis was used for the qualitative data.

Result: Forty percent of patients with TB had not received patient-centered TB care (PC-TB care) with DOTS. Male gender (AOR = 0.45, 95% CI 0.3, 0.7), good communication (AOR = 3.2, 95%CI 1.6, 6.1), and health care providers as a treatment supporter (AOR = 3.4, 95% CI 2.1, 5.48) had significant associations with PC-TB care. All persons lost to follow-up and TB experts perceived that DOTS is merely patient-centered. The identified categories were patient preferences, treatment supporter choice, integration of DOTS with nutritional support, mental health, and transport services, provider's commitment and communication skills.

Conclusion: DOTS is limited to provide patient-centered TB care. Hence, DOTS needs a model that enhances effectiveness towards patient centeredness of TB care.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. tif Mean score of PCC dimensions (N = 601).
Fig 2
Fig 2. tif Perceived PCC and registration category.
See this image and copyright information in PMC

References

    1. World Health Organization. Geneva, Global tuberculosis report 2012.
    1. Otu AA. Is the directly observed therapy short course (DOTS) an effective strategy for tuberculosis control in a developing country? Asian Pacific Journal of Tropical Disease. 2013. April 30;3(3):227–31.
    1. Diacona HA, Groote-Bidlingmaierb F & Donald RP. 2012. From magic mountain to table mountain. Swiss Medical Weekly 142:1–9. - PubMed
    1. Jassal SM & Bishai RW. 2010. Epidemiology and challenges to the elimination of global Tuberculosis. CID:50 (Suppl 3):S163 Available at: http://cid.oxfordjournals.org (accessed on 25 December 2014). - PMC - PubMed
    1. Moonan KP, Quitugua NT, Pogoda MJ, Woo G, Drewyer G, Sahbazian, et al. 2011. Does directly observed therapy (DOT) reduce drug resistant tuberculosis? Bio Med Central Public Health 11(19):1–8. - PMC - PubMed

Publication types

Substances