Document Detail


Community-randomized trial of enhanced DOTS for tuberculosis control in Rio de Janeiro, Brazil.
MedLine Citation:
PMID:  20074412     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2010-01-15     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  IM    
Affiliation:
Municipal Health Secretariat, Rio de Janeiro, Rio de Janeiro, Brazil. drsocavalcante@yahoo.com.br
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MeSH Terms
Descriptor/Qualifier:
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:
AI 01637/AI/NIAID NIH HHS; AI 45432/AI/NIAID NIH HHS; TW05574/TW/FIC NIH HHS
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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