Comparison of Outcomes from a District Tuberculosis Control Programme in the Pacific: Before and after the Implementation of DOTS

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Abstract
Outcomes are compared for a district tuberculosis (TB) control programme, before and after DOTS (directly observed therapy short-course) and a computerized register were introduced. There were significant improvements in case holding associated with the interventions. The successful treatment rate was 13.6% [95% CI (confidence interval), 4.9-23.0] higher and the default rate 9.6% (95% CI, 3.6-17.3) lower following the introduction of DOTS and the computerized register. There was no difference in cure rates or death rates, the notification of new cases, the proportion of pulmonary cases or sputum positives. Additional benefits associated with the computerized register were improvements in supervision, reporting and statistical analysis. The short-course chemotherapy permitted flexibility and was well accepted by both health staff and patients. This study demonstrates that computerization of TB registration using appropriate software is feasible in district TB programmes in resource poor countries and can contribute to improving their performance.