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Task shifting for tuberculosis control

A qualitative study of community-based directly observed therapy in urban Uganda

Bibliographic Data

ID15541237
AuthorsDavid Kaawa‐mafigiri (0000-0002-2699-4248, Makerere University, corresponding author), Janet W Mcgrath (Case Western Reserve University), Christopher C Whalen (0000-0002-8081-0665, University of Georgia)
Year2011
Volume7
Issue3
Pages270-284
Publication date2011-02-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueGlobal Public Health (JOURNAL)
Journal identifiersISSN: 1744-1692 • E-ISSN: 1744-1706
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17441692.2011.552067
PMID21360381
PMCIDPMC3603570
OpenAlexW2045299282
LanguageEN
Citations received10
References cited16

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

Directly Observed Therapy · Environmental health · Family medicine · Geography · Pathology · Qualitative research · Social science · Sociology · Task (project management · Tuberculosis · Tuberculosis control · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine · Psychology · Tuberculosis Research and Epidemiology

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Unique citing works10
Citations per year0,67
Citation span2011 - 2026 (16)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 10
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