| Community-randomized trial of enhanced DOTS for tuberculosis control in Rio de Janeiro, Brazil. | |
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MedLine Citation:
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PMID: 20074412 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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SETTING: Central Rio de Janeiro, Brazil. OBJECTIVE: To compare the impact of routine DOTS vs. enhanced DOTS (DOTS-Ampliado or DOTS-A) on tuberculosis (TB) incidence. DESIGN: Cluster-randomized trial in eight urban neighborhoods pair-matched by TB incidence and randomly assigned to receive either the DOTS-A or DOTS strategy. DOTS-A added intensive screening of household contacts of active TB cases and provision of treatment to secondary cases and preventive therapy to contacts with latent TB infection (LTBI) to the standard DOTS strategy. The primary endpoint was the TB incidence rates in communities after 5 years of intervention. RESULTS: From November 2000 to December 2004, respectively 339 and 311 pulmonary TB cases were enrolled and 1003 and 960 household were identified in DOTS and DOTS-A communities. Among contacts from DOTS-A communities, 26 (4%) had active TB diagnosed and treated, 429 (61.3%) had LTBI detected and 258 (60.1%) started preventive therapy. TB incidence increased by 5% in DOTS communities and decreased by 10% in DOTS-A communities, for a difference of 15% after 5 years (P = 0.04). CONCLUSION: DOTS-A was associated with a modest reduction in TB incidence and may be an important strategy for reducing the burden of TB. |
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Authors:
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S C Cavalcante; B Durovni; G L Barnes; F B A Souza; R F Silva; P F Barroso; C I Mohan; A Miller; J E Golub; R E Chaisson |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease Volume: 14 ISSN: 1815-7920 ISO Abbreviation: Int. J. Tuberc. Lung Dis. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-15 Completed Date: 2010-03-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706389 Medline TA: Int J Tuberc Lung Dis Country: France |
Other Details:
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Languages: eng Pagination: 203-9 Citation Subset: IM |
Affiliation:
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Municipal Health Secretariat, Rio de Janeiro, Rio de Janeiro, Brazil. drsocavalcante@yahoo.com.br |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antitubercular Agents / administration & dosage*, therapeutic use Brazil / epidemiology Contact Tracing Directly Observed Therapy / methods* Family Characteristics Female Follow-Up Studies Humans Incidence Male Mass Screening / methods Tuberculosis / epidemiology, prevention & control* Urban Population |
| Grant Support | |
ID/Acronym/Agency:
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AI 01637/AI/NIAID NIH HHS; AI 45432/AI/NIAID NIH HHS; TW05574/TW/FIC NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antitubercular Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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