Cost-effectiveness of community health worker versus home-based guardians for directly observed treatment of tuberculosis in Vitória, Espírito Santo State, Brazil

Datos Bibliográficos

ID5231901
AutoresThiago Nascimento Do Prado (0000-0001-8132-6288, Universidade Federal do Espírito Santo), Nikolas Wada (Johns Hopkins University), Nikolas I Wada (0000-0002-6699-4154, Johns Hopkins University), Leticia Molino Guidoni (0000-0003-3737-5407, Universidade Federal do Espírito Santo), Jonathan E Golub (0000-0003-2398-3145, Johns Hopkins University), Reynaldo Dietze (0000-0002-6995-8001, Universidade Federal do Espírito Santo), Ethel Leonor Noia Maciel (0000-0003-4826-3355, Universidade Federal do Espírito Santo)
Año2011
Volumen27
Número5
Páginas944-952
Fecha de publicación2011-05-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaCadernos de Saude Publica (JOURNAL)
Identificadores de la revistaISSN: 0102-311X • E-ISSN: 1678-4464
EditorialFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/s0102-311x2011000500012
PMID21655845
OpenAlexW2146147720
SCIELO_PIDS0102-311X2011000500012
IdiomaEN
Citas recibidas6
Referencias citadas16

The objective of this study was to compare the costs and outcomes associated with guardian-supervised directly observed treatment relative to the standard of care Directly Observed Therapy, Short Course (DOTS) provided by community health workers (CHW). New cases of culture-positive pulmonary tuberculosis (TB) treated in Vitória, Espírito Santo State, Brazil, between January 2005 and December 2006 were interviewed and chose their preferred treatment strategy. Costs incurred by providers and patients (and patients' families) were estimated, and cost-effectiveness was assessed by comparing costs per successfully treated patient. 130 patients were included in the study; 84 chose CHW-supervised DOTS and 46 chose guardian-supervised DOTS. 45 of 46 (98%) patients treated with guardian-supervised DOTS were cured or completed treatment compared to 70/84 (83%) of the CHW-supervised patients (p = 0.01). Logistic regression showed only the strategy of supervision to be a significant association with treatment outcome, with guardian-supervised care strongly protective. Cost per patient treated with guardian-supervised DOTS was US$398, compared to US$548 for CHW-supervised DOTS. The guardian-supervised DOTS is an attractive option to complement CHW-supervised DOTS

Directly Observed Therapy · Family medicine · Guardian · Logistic regression · Pathology · Tuberculosis · Internal Medicine · Medicine · Parasites and Host Interactions · Pneumonia and Respiratory Infections · Tuberculosis Research and Epidemiology