Directly Observed Treatment Short Course Strategy Research Articles

TUBERCULOCIDAL AND TUBERCULOSTАTIC ACTIVITY OF 1,2,4-TRIAZOLE DERIVATIVES IN VITRO (DETERMINATION OF MIC (MINIMUM INHIBITORY CONCENTRATION)

In recent years, the epizootic and epidemic situation of tuberculosis in animals and humans has worsened sharply in Ukraine. This is facilitated by the constant change in the morphology and biological properties of the causative agent of tuberculosis, the low efficiency of existing laboratory diagnostic methods (outdated bacteriology standards that do not meet European requirements), the emergence of multi-resistant strains of mycobacteria that are difficult to treat. Therefore, in recent decades, scientists of the world have been actively working on the creation of new chemotherapeutic agents with potential tuberculocidal and tuberculostatic activity.
 In recent decades, cases of isolation of multi-resistant strains of mycobacteria have been increasingly recorded, causing infection that is difficult to treat, which poses a significant threat to the health of animals and people. The World Health Organization constantly monitors the situation of epidemic and socially significant diseases in the world. Particular attention is paid to tuberculosis. In the last decade, the WHO has developed and successfully applied the so-called DOTS strategy in the world. The essence of DOTS (Directly Observed Treatment Short-course) is strictly controlled treatment with a short course of chemotherapy. Therefore, the search for new chemotherapeutic drugs for the treatment of tuberculosis infection is a priority area of pharmaceutical chemistry.
 One of the promising similar drugs are triazole derivatives, the active development of which continues at the department of natural sciences for foreign students and toxicological chemistry of the Zaporizhzhia State Medical University. Therefore, the direction of influence of these derivatives on epizootic strains of mycobacteria, the causative agents of animal tuberculosis, is promising.

Hambatan Pelaksanaan Program Directly Observed Treatment Short-Course (DOTS) Di Negara Berkembang: Sebuah Tinjauan Sistematik

Tuberculosis is a global burden with most cases occurring in developing countries. After the implementation of Directly Observed Treatment Short-course (DOTS), the incidence of tuberculosis decreased. Despite, studies reported constraints in implementing this program. This study aims to describe the challenges of DOTS implementation in developing countries narratively. Methods: a search strategy through PUBMED was used to identify relevant articles. 10 relevant articles were included from 349 records. The studies were conducted in 8 developing countries namely South Africa, Sub-Saharan Africa, Brazil, Ethiopia, Indonesia, Angola and Nigeria. All articles included was extracted and categorized in ten main points regarding the challenges of the implementation of DOTS program. Results: There were 10 main points of challenges in implementing the DOTS strategy in developing countries : lack of access to health centres, managerial and organizational service problems, lack of health education-related tuberculosis, lack of supervision, TB co-infection, lack of trained health workers, smoking, alcohol, and drug abuse during treatment, patient-health professional relationship, lack of food availability and interruption during treatment. Conclusion: The implementation of the DOTS strategy encounters many challenges in developing countries where lack of health facilities, managerial and organizational service problems and lack of education-related TB are the main challenges to implement the program

Hambatan Pelaksanaan Program Directly Observed Treatment Short - Course (DOTS) di Negara Berkembang : Sebuah Tinjauan Sistematik

Tuberculosis is a global burden with most cases occurring in developing countries. After the implementation of Directly Observed Treatment Short-course (DOTS), the incidence of tuberculosis decreased. Despite, studies reported constraints in implementing this program. This study aims to describe the challenges of DOTS implementation in developing countries narratively. Methods a search strategy through PUBMED was used to identify relevant articles. 10 relevant articles were included from 349 records. The studies were conducted in 8 developing countries namely South Africa, Sub-Saharan Africa, Brazil, Ethiopia, Indonesia, Angola and Nigeria. All articles included was extracted and categorized in ten main points regarding the challenges of the implementation of DOTS program. Results: There were 10 main points of challenges in implementing the DOTS strategy in developing countries : lack of access to health centres, managerial and organizational service problems, lack of health education-related tuberculosis, lack of supervision, TB co-infection, lack of trained health workers, smoking, alcohol, and drug abuse during treatment, patient-health professional relationship, lack of food availability and interruption during treatment. The Conclusion is the implementation of the DOTS strategy encounters many challenges in developing countries where lack of health facilities, managerial and organizational service problems and lack of education-related TB are the main challenges to implement the program.

Compliance of patients to DOTS tuberculosis treatment strategy in a South-East Nigeria Teaching Hospital.

Tuberculosis ranks the second highest cause of adult mortality after HIV in the world. The Directly Observed Treatment Short course (DOTS) strategy is aimed at following up on patients' adherence to treatment regimen. To assess the level of compliance of patients to the DOTS strategy. A retrospective study of patients seen at the University of Nigeria Teaching Hospital from January, 2013 to April, 2015. Relevant information was collected from patients' folders. Data analysis was with the SPSS and results represented in tables. 111 (50%) patients were compliant with their DOTS treatment plan while 107 (41.3%) were non-compliant. Ninety-two patients (41.4%) were successfully treated and discharged home, 7 patients (3.2%) referred to other centres. The proportion of patients regarding their marital status, occupation, educational level and address that was compliant to the DOTS TB reflected varied patterns. The study reflected poor to average compliance to DOTS. There is a need for creation of more DOTS centres; regular surveys and updates on DOTS TB strategy should be the norm rather than the exception.

Analisis Program Pengendalian Tuberkulosis dengan Strategi DOTS di Puskesmas Manutapen Kupang

Background: Tuberculosis (Tb) is a global challenge for public health problems, including Indonesia. Kupang is the city in East Nusa Tenggara (NTT) that has the highest number of Tb cases with a Success Rate (SR) about 85% in 2017. However, in 2018 the SR rate decreased to about 81%. Adherence to taking medication can have an effect on increasing the SR rate. In NTT, had many cases of withdrawal problems caused by Tb patient not taking medication regularly. The Tb control Program in NTT is based on the Directly Observed Treatment Short Course (DOTS) Strategy that focuses on case finding and cure rates. The five components of DOTS are: 1) Political commitment 2) Case finding 3) Standard treatment 4) Drug management and availability systems 5) Monitoring, recording and reporting system. The purpose of this study is to analyze the implementation of DOTS strategy in Manutapen Public Health Center (Puskesmas)Methods: This study was a descriptive qualitative method with used in-depth interviews. The main informants were three health officer participants from the Puskesmas. Triangulation informants were one participant of the Disease Control and Prevention Program of the Kupang Health Officer, one PMO participant, and one Tb patient participant.Result: Tb control with DOTS strategy encountered obstacles including a lack of political commitment related to funding new Tb cases, the high workload made the Tb officers unable to monitor the patients, and unreported cases.Conclusion: Tuberculosis control program with the DOTS strategy in Manutapen Public Health Center kupang was not optimalized.

Directly observed treatment short-course in management of peripheral tubercular lymphadenitis

Background: Tuberculosis (TB) is a major public health problem worldwide. It is one of the main causes of infectious disease and mortality, especially in the developing countries, and has been recognized as one of the top ten causes of death worldwide by the World Health Organization. Aims and Objectives: The aims of this study were to assess clinical pattern and efficacy of Directly Observed Treatment Short-Course (DOTS) in management of peripheral tubercular lymphadenitis. Materials and Methods: This was a prospective, observational study among pediatric peripheral tubercular lymphadenitis patients to assess the clinical pattern, investigations, and treatment outcome. Results: In this study, 72 patients having peripheral tubercular lymphadenitis were enrolled. Most cases had cervical node involvement (81%). Discharging sinus was found in 28.98% cases. Acid-fast bacillus (AFB) was detected by fine needle aspiration and cytology (FNAC) in 21 cases (30.43%). Among them, pulmonary TB was found in two cases (9.52%), one patient being sputum positive. After treatment completion, lymph node(s) enlargement persisted in 6 (8.69%) cases, of which two patients (2.89%) had persistent discharging sinus. On repeat FNAC, acid-fast bacilli were seen in two patients. Success rate was 91.3% confirming the efficacy of DOTS in the management of tubercular lymphadenitis. Conclusions: Cervical lymphadenitis was found to be most common type of peripheral lymphadenitis. Cytopathology from the suspected lymph nodes had better success rate than AFB detection or CBNAAT of FNAC samples for diagnosing tubercular etiology in the study. DOTS strategy was effective for peripheral tubercular lymphadenitis with high success rate in this study.

Treatment outcomes of tuberculosis patients in a Directly Observed Treatment Short course (DOTS) Referral Centre in Delta State, Nigeria: a five-year review (2012 - 2016).

The objective of this study is to observe the trend in treatment outcomes and identify determinants of treatment success among patients recruited into care through the DOTS strategy. A retrospective record review of tuberculosis patients (2012-2016) was carried out at the Tuberculosis and Leprosy Referral Centre, Eku, Delta State, Nigeria. Records of four hundred and twenty five (425) tuberculosis patients under DOTS were reviewed over five years. The highest number of cases under treatment, 102 (24.0%), was recorded in 2013. The mean age (SD) of patients was 37.3 (±16.5) years, majority of the patients were male (62.4%) and 18% had TB/HIV co-infection. Treatment outcomes of patients were cured (53.4%), completed (27.8%), died (6.8%), failed (2.4%), lost to follow up (4.9%), transferred out (1.2%) and not evaluated (3.5%). Over all, treatment success rate was 81.2% with a trend of 88.7% (2012), 87.3% (2013), 85.9% (2014), 65.0% (2015) and 65.8% (2016) respectively. Patient characteristics were not associated with treatment success. The treatment success rate was high and in line with the national recommendation of 80% and above. The trend showed a reduction in number of new cases enrolled into the DOTS programme, reduction in success rate with a concomitant increase in loss to follow up. There was no association between patient characteristics and TB treatment success. System strengthening on patient follow up, community health education and treatment adherence is recommended.

Comparing the Treatment Outcomes of Tuberculosis Patients in a Private Clinic with a Governmental Health Center in Jimma City, Ethiopia: Retrospective Study.

BackgroundTuberculosis (TB) is a common and often deadly infectious disease caused by various strains of mycobacterium, usually mycobacterium tuberculosis in humans. The disease has major causes of morbidity and mortality, particularly where the diagnostic and control program is not far extended.ObjectiveTo compare the treatment outcomes of tuberculosis patients in a private clinic with a governmental health center in Jimma city, Ethiopia.MethodsA 10-year cross-sectional retrospective systemic record review was conducted to compare the treatment outcomes, and to describe the socio-demographic factors associated with the outcome in a private clinic with a governmental health center in Jimma city, Jimma, Ethiopia from September 12, 2007, to September 10, 2017. Finally, SPSS/EPI INFO analyzed data.ResultsThe present study revealed that within a 10 year duration the private clinic gives anti-TB treatment coverage for 582 patients whereas the governmental health center treats 510 patients. The treatment success rate of the private clinic is 98.1% which is 1.03-fold that of the governmental health center (95.3%); while the treatment failure of the private clinic was 0.2%, but there was no treatment failure in the governmental health center.ConclusionBoth sectors achieved the expected WHO targets by newly recommended strategy for TB treatment, DOTS (Directly Observed Treatment Short Course) and treatment success is much better to standard. This shows good progress of DOTS strategy and a decrease of noncompliance in this area. Age, educational level, and the types of TB diagnosis and treatment outcome of the patients were statistically associated in both sectors. Better counseling and awareness about the disease should have to be given for every anti-TB treatment receiving patients, despite their educational level and occupational status in both sectors.

Faktor-Faktor Kesembuhan Penderita TB Paru Dengan Penyakit Penyerta Diabetes Melitus

In increasing the coverage of cures for patients with pulmonary tuberculosis (TB), the Government created a DOTS (Directly Observed Treatment Short-Course) Strategy program, which is a treatment program that focuses on supervision to ensure compliance of pulmonary TB patients in swallowing drugs. In this strategy, the drug taking supervisor (PMO) and the family have a very big role. The purpose of this study was to determine the factors associated with the recovery of people with pulmonary tuberculosis with co-morbidities with diabetes mellitus. This study uses a correlational research design with a cross sectional study approach with a research sample of 119 respondents taken by total sampling technique. The results showed that people with pulmonary TB with DM in the area of ​​the Cilegon City Health Office were mostly obedient in taking OAT (62.2%), most of them had PMO (79.8%), most of them received good support from the community. his family (54.6%) and almost completely recovered after treatment (80.7%). There is a relationship between adherence to taking OAT (pv: 0.005), availability of PMO (pv: 0.019) and family support (pv: 0.0001) with the recovery of pulmonary TB patients with DM co-morbidities. The results of this study indicate that PMO and family are very important variables in the treatment of patients with pulmonary tuberculosis, their main role is to ensure that patients with pulmonary tuberculosis are obedient in undergoing treatment according to a predetermined program. It is hoped that PMO and their families will further enhance their role in the treatment of patients with pulmonary tuberculosis, especially in supervising medication adherence.
 Keywords: pulmonary tuberculosis, pmo, family support, co-morbidities, diabetes mellitus
 
 Keywords: pulmonary tuberculosis, comorbidities, DM.

Implementation of Management of Pulmonary Tuberculosis with the Directly Observed Treatment Short course Strategy

The purpose of this study was to describe the implementation of pulmonary TB disease management with the DOTS strategy at the Jagong Health Center, Central Aceh Regency.The implementation of Pulmonary TB Management with the DOTS (Directly Observed Treatment Shortcourse) strategy in the working area of the Jagong Health Center, Central Aceh Regency has been maximized. by facilitating and providing motivation so that patients want treatment in a complete and integrated manner, case detection can be carried out by health workers or cadres who have been given training to recognize the symptoms of pulmonary TB. The distribution of drugs is distributed to each puskesmas in Central Aceh Regency, from the Puskesmas the drugs are arranged directly by P2TB officers then given directly to the PMO or the patient himself. PMO performance has never been given special training about treatment, PMO only received direction from P2TB Pulmonary officers. Recording and reporting carried out at the Jagong Health Center includes case finding, treatment, and recovery. Suspected pulmonary TB will be recorded and then monitored until the results of the examination have been obtained. Recording and reporting will be reported every month in a meeting at the Central Aceh District Health Office. For the Central Aceh Regency government to further enhance the development and improvement of infrastructure in the health sector so that health services are more easily accessible to people in remote areas.

THE INFLUENCE OF TRANSFORMATIONAL LEADERSHIP ON NURSE PERFORMANCE IN TUBERCULOSIS TREATMENT: A NARRATIVE REVIEW

Background: World Health Organization (WHO) has established a Directly Observed Treatment Short-Course (DOTS) strategy. Carrying out the DOTS strategy, the public health center is running the TB Prevention and Treatment program, in Indonesia it is called prevention and countermeasures of tuberculosis (P2TB) but in reality, the P2TB program has not been effectively implemented. Health workers who play an important role in carrying out their roles and duties in society are nurses. One of the efforts to improve the performance of nurses in TB treatment is the application of transformational leadership. The purpose of this literature review is to examine the results of the past 10 years of research related to the influence of transformational leadership on nurse performance in tuberculosis treatment. Design: This study design is a literature review to search and review article from database and theory underlying this study or guidance in this literature review using Preferred Reporting Items for Systematic Reviews and PRISMA. Data Sources: The data base used in the article searches used include: Science Direct, PubMed, Google scholar, EBSCO using the keywords transformational leadership, nurse performance, tuberculosis treatment. The articles used are those between the years 2009-2019. Review Methods: The review method for this literature review using a narrative method by classifying the similar extracted data according to the research findings. Results: The main component of transformational leadership to improve The performance of nurses to play a more optimal role in an effective and efficient TB treatment effort is an idealized influence, which is that nurses have charismatic, in the fact that nurses in providing nursing care in the community must provide good paragons and become role models in the field of good health to individuals, families, groups and communities about how to live clean and healthy as behavior that can be imitated by the community, inspirational motivation for nurses as health teacher educators or health counselling which is a part of health promotion, the nurse's intellectual stimulation empowers communities to solve health problems in the community through small group discussions, and individual consideration, in this case the nurse's duty is as an advice provider and counseling is highly important and beneficial for the community. In order to achieve the fulfillment of the roles and responsibilities of nurses, there must be inner motivation among nurses in order that they can provide decent motivation to the community. Conclusion: Transformational leadership can be applied to improve the performance of nurses in TB treatment efforts.

Social Medicine Approach in the Management of Lung Tuberculosis (TB) in North Aceh Regency: Role of Government and Non-Governmental Organization

The Directly Observed Treatment, Short-course (DOTS) strategy has been proven effective in controlling tuberculosis (TB); nevertheless, TB's community burden is still very high. This study aims to determine the role of non-governmental organizations (NGOs), health cadre, and health workers in the North Aceh Regency in overcoming TB. This study used qualitative research methods. The results showed a reasonably synergistic collaboration between NGOs, health cadres, and health personnel in the TB control program. In general, the TB control programs are inclined with national programs such as TOSS TB (Find Treat and Cure TB), implementing DOTS strategy, counseling to prevent TB transmission, and nutrition monitoring. However, the targets of each program have not been fully achieved. This study found several obstacles in the field, such as the lack of program implementation funds, the increasing number of MDR-TB cases, and TB co-infection diseases. Keywords: Tuberculosis, NGOs, health cadres, health personnel DOI: 10.7176/JHMN/95-07 Publication date: November 30 th 2021

Stability analysis of a tuberculosis epidemic model with nonlinear incidence rate and treatment effects

We present a tuberculosis epidemic model with nonlinear incidence rates. The mathematical model consists of five variables that are susceptible, exposed, infectious, and recovered. Where infectious is divided into two categories, the first is latent infectious and the second categories is MDR (Resistant). The parameters on infectious describe the level of tuberculosis’s treatments are the treatment for the prevention of epidemic tuberculosis is by chemoprohylaxis for the the exposed individuals. Whereas treatment for infected individuals uses anti-tuberculosis drug theraphy with the directly observed treatment short course strategy(DOTS). The research method uses analytical (using the MAPLE) and numerical (using the MATLAB application) analysis. The steps in the analytical analysis include making a tuberculosis disease model, determining the point of equilibrium, and analyzing stability. Meanwhile, numerical analysis is used to explain the dynamic simulation of the spread of tuberculosis and the effectiveness of the treatment. The results of this research obtained are two equilibrium points (endemic and non-endemic) with a condition of conditional stability for each point. The stability will apply if the conditions proposed are met, namely local stability at a point of non-endemic equilibrium (ε 0) is stable if ℜ0 less than 1 and endemic equilibrium point (ε *) will be stable if ℜ0 more than 1. From the results of analytic calculations and numerical simulations, by using Ruth-Hurwitz Method ℜ0 = 0.312 at the non-endemic point and Centre Manifold method on endemic point is ℜ0 = 0.312. So it can be concluded that the treatment on the first stage is more important to protect on TB spread.

Tuberculosis control within Indonesia's hospital accreditation.

Background: Tuberculosis (TB) is an infectious disease that is a major problem in Indonesia, placing Indonesia among the three major countries with the highest TB cases in the world. In addition, reporting of TB data from health service facilities, especially hospitals, is still weak. Since the implementation of Directly Observed Treatment Shortcourse (DOTS) in hospitals in 1995, the number of new TB case reports from hospitals is still low. In order to increase hospital participation in TB control, the government has made a breakthrough strategy, which is the integration of the DOTS strategy in hospital accreditation.Design and methods: This study conducted a literature review and document analysis related TB control standards in hospital accreditation and the implication for the involvement of hospitals in national TB program. This study analyzed regulations, policies, and procedures, including hospital accreditation instruments and annual reports of TB.Results:Accreditation standards related to TB control include: i) Hospital must implement a tuberculosis control program in the hospital, including monitoring and evaluation through activities such as health promotion, tuberculosis surveillance, controlling risk factors, detection and treatment of tuberculosis cases, providing immunity and preventive drugs; ii) Hospital prepares resources for service delivery and tuberculosis control; iii) hospital provides facilities and infrastructures for tuberculosis services in accordance with regulations; and iv) hospital conducts tuberculosis services and efforts to control tuberculosis risk factors in accordance with regulations.Conclusions: Standards and elements of the assessment of TB control components in accreditation are adjusted to the national TB control guidelines. Significance for public health Accreditation is an essential element to assess the quality of the hospital handling health problems in the clinical setting. Implementing the hospital accreditation in Indonesia especially for the DOTS strategy requires several standards according to the national TB control guidelines. As a result, achieving optimal TB control through the hospital accreditation and ensuring the quality of care for a patient can be reached. The health worker and public health system take responsibility to ensure implementing the standards of accreditation to control TB cases and achieve effective management.

Basic Reproduction Number of Tuberculosis Spread Model in Lamongan With DOTS Strategy

Tuberculosis (TB) will be a serious threat if not handled quickly and appropriately. The relatively long treatment in time and the high risk of death is a challenge in controlling the spread of this disease. The DOTS (Directly Observed Treatment Short-course) strategy is considered capable of controlling the spread of TB because of the high success rate, reaching 91%. The mathematical model of the spread of TB has been widely studied to determine the potential for the spread of this disease in an area. The purpose of this study is to build a model of tuberculosis spread in Lamongan to determine the rate of its spread and to predict whether it will be endemic or not. Using disease spread mathematical model type SEITR, this research has examined based on 2018 and 2019 data from the Lamongan health office then simulates the result. The research begins with the construction of the model followed by a stability analysis of the model by determining the basic reproduction number ( ), which is simulated after the parameter approach was carried out. From the simulation results, the result shows that means that TB will not endemic in Lamongan. Besides, the results of the effect of parameter ω on I(t) were obtained, which concluded that seeking and treating active TB alone would only reduce infected individuals but not reduce the length of time TB spread. Identification of the effect of parameter φ on I(t) has also been carried out which results in the conclusion that more treatment for susceptible individuals, in addition to reducing the number of infected individuals, will also reduce the length of time TB spreads in that area. This result will be a good suggestion for the government to deal faster with tuberculosis transmission.

The Strategy of Directly Observed Treatment Shortcourse (DOTS) Towards Compliance with Treatment of Tb Lung Patients in Tb Lung Mamuju District Hospital, Indonesia

Objective: The purpose of this study was to determine the relationship between the DOTS strategy, drug swallowing supervisors (PMO) and the procurement of anti-tuberculosis drugs (OAT) with compliance with treatment at Mamuju Regional Hospital. Method: The research method used was descriptive-analytic with design cross-sectional, using statistical test Spearman Correlation (Rho) Total sample of 29 people. Primary data obtained from interviews using a questionnaire. The data is processed using the SPSS 16.00 computer program then presented in the frequency distribution table and its analysis. Results: The results showed supervisors swallowed drugs with medication adherence due to positive and strong direction p = 0.00 (p 0.05) and r = 0.246. Conclusion: There is a relationship between the drug swallow supervisor (PMO) with medication adherence and the direction of the relationship is positive and strong.

Implementasi Program Penanggulangan TB Paru dengan Strategi Directly Observed Treatment Shortcourse di Puskesmas Panyabungan Jae Kabupaten Mandailing Natal

TB cases in Southeast Asia contribute 40% of the world's TB cases and causes the highest mortality in Indonesia. Panyabungan Jae Health Center (PJHC) itself has the highest number of TB cases in Mandailing Natal Regency. This study, therefore, aimed to determine the implementation of the TB Control Program with the Directly Observed Treatment Shortcourse Strategy (DOTS) at PJHC.Qualitative methods with descriptive approach was used for this research. In-depth interviews was conducted with 5 informants in July 2020. The data were analyzed using data reduction, data presentation, and conclusion drawing.The research found that communication between the TB program officer and the DOTS strategy worked well in the PJHC as well as the disposition, resources and bureaucratic structures. Political commitment in the DOTS strategy with cross-sectoral cooperation has an important influence in the handling of TB cases,however village authorities have not played a role in efforts to reduce for number of TB cases. The patients had lack of understanding about TB and some localshad views TB as a disease caused by poison becomes an obstacle in treating patients. TB prevention with the DOTS strategy at the PJHC runs according to standard guidelines, and complemented by the Puskesmas innovation "Tor Tor Libas TB".The MNDHO officersare advised to collaborate with entire stakeholders in overcoming TB by strengthening education in the form of routine counseling to increase public knowledge about TB

Paediatric Tuberculosis at the Directly Observed Treatment Short-Course Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Introduction: Tuberculosis (TB) is the leading infectious disease killer worldwide, despite significant progress against the disease in recent years. Most cases of TB in children occur in the TB endemic countries but the actual burden of paediatric TB is unknown. With early diagnosis and treatment using the first-line anti-tuberculous drugs, most people who develop the disease can be cured and onward transmission of infection curtailed.
 Objective: To determine the pattern and outcome of paediatric tuberculosis managed at a tertiary facility in Sokoto, Nigeria.
 Materials and Methods: Records of children managed for TB at the Directly observed treatment short-course (DOTS) clinic over a three-and-a-half-year period were reviewed retrospectively. All children (≤ 15 years) treated for TB over the study period was included. Relevant information was retrieved from the register and analysed accordingly.
 Results: 74 children were treated with 33(44.6%) being males, giving a M: F ratio of 1:1.2. Mean (±SD) age was 85.78 (±55.40) months and 34 (45.9%) belonged to the 0.0-5.0-year age group. Seventy-one (95.9%) were new cases and three (4.1%) were relapse. Pulmonary TB (PTB) was seen in 50 (67.6%), more females had PTB than males, which was not significant (χ2=0.4, p=0.52).
 Acid fast bacilli (AFB) were positive in only 8 (10.8%) while GeneXpert MTB/RIF sensitivity was detected in 7 (9.2%). Majority 36 (48.6%) were lost to follow up, 30 (40.5%) completed treatment, only 4(5.4%) were cured with no recorded mortality. Successful treatment outcome was low (45.9%).
 Conclusion: Treatment outcome using DOTS strategy was poor, far below the WHO benchmark. There is need to improve adherence to DOTs therapy to prevent development of multi drug resistant TB.

FAKTOR RISIKO KETIDAKPATUHAN PENGOBATAN PENDERITA TUBERKULOSIS PARU DI KOTA KENDARI

Tujuan dari penelitian adalah menganalisis faktor risiko ketidakpatuhan pengobatan pasien Tuberkulosis Paru. Penelitian ini menggunakan desain kasus kontrol, dengan 136 responden terdiri dari 68 kasus dan 68 kontrol. Sampel kontrol adalah semua pasien TB baru berusia 15 tahun ke atas dan mematuhi pengobatan. Analisis data dengan sistem tabulasi dan statistik odds rasio. Hasil penelitian menunjukkan dari lima variabel yang dianggap berisiko terhadap ketidakpatuhan untuk minum obat, ada dua variabel yang ditemukan memiliki risiko ketidakpatuhan, yaitu pengetahuan OR sebesar 5,492, dan pengawas aktivitas untuk minum obat OR sebesar 4,166. Pengetahuan, pengawas aktivitas minum obat merupakan faktor risiko terhadap ketidakpatuhan pengobatan pasien TB di kota kendari

Validation of logical models for the management of tuberculosis treatment.

to describe the steps of validation of the logical models of the Directly Observed Treatment and the Information System of the Directly Observed Treatment Short-Course Strategy. methodological study carried out from February to June 2018, in two stages. The content of the items that make up the models was based on scientific evidence and submitted to the experts for content validation. The Content Validity Index was applied, accepting the value ≥ 0.80. the agreement, regarding its validity, was satisfactory in the 79 items analyzed. The logical models were considered valid with a Global Validity Index of 0.91 for the Directly Observed Treatment and 0.87 for the Information System. the logical models were considered valid in terms of content, being a useful and timely instrument to support managers in decision-making.