The Influence of DOTS policy on Patient with Tuberculosis

• Main Authors: Shao- ting Chou, 周紹庭
• Other Authors: Shu-Chuan Jennifer Yeh
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/543zc8

碩士 === 國立中山大學 === 高階經營碩士班 === 97 === Background and purpose: Tuberculosis (TB) is one kind of chronic infectious disease which caused by the mycobacterium tuberculosis, and still widely exists in the world. In Taiwan, there are approximately 15,000 new tuberculosis patients and 1,300 died annually. The incidence and mortality rate rank the number one among the legal reported disease in Taiwan. Therefore, how to prevent and control the tuberculosis becomes a crucial policy for Centers for Disease Control (CDC) in Taiwan. Directly Observed Treatment, Short-course (DOTS) is a TB control program implemented in many countries aggressively by the World Health Organization (WHO) since 1993. The implementation method is that patients are supervised by well-trained health care staff while medication is administered, to assure the clients taking each dose of medicine. This policy is intended to cure the patient in time, cutting off the infectious sources, prevent the efficacy of anti-tuberculosis drugs and cease the emerging of multidrug resistant tuberculosis (MDRTB) . For the long-term planning and the target of “Halve the TB over the next ten years,” the CDC of Taiwan has been enforced the DOTS program since April 1st, 2006. The rate implementing DOTS in smear- positive case has been exceeded 90%. The purpose of this study is to examine the effect of DOTS policy on the outcomes of Tuberculosis before and after the DOTS policy implementation. Methods: The secondary databases from the study hospital were retrieved. The data included 24 months before and after the DOTS implementing (April 1st, 2006). We investigated if there’s significant improvement in treating tuberculosis after the DOTS. Both descriptive and Chi-square tests were used to depict the study sample and to examine the correlation between treatment outcome and DOTS, respectively. Results: There is no difference on treatment outcome between male and female. Male had higher cavity formation on the chest x-ray. There’s more easy treatment completion when the clients were younger than 65 years old. No cavity on the chest x-ray was statistically associated with negative acid fast stain. The chest x-ray showed cavity was related to higher completion rate of treatment. There’s no correlation between the acid fast stain and treatment completion. There’s no significant difference on treatment outcome after the DOTS implementing. Conclusions: There’s no difference in treatment result between the “DOTS” and “without DOTS” group after April 2006. The reason we deliberate that may be the study hospital is located at the urban area, which is high prevalence area in tuberculosis and thus have been under control for years. The completion rate in tuberculosis treatment is already high enough. No wonder there’s no such difference. Anyway, we can not ignore the policy of the DOTS, we must keep cooperation with this policy, make great efforts on tuberculosis prevention and control in Taiwan.