Directly observed therapy for tuberculosis: The Harlem Hospital experience, 1993

Abstract

Objectives. A directly observed therapy program was established at Harlem Hospital, New York, NY, in 1993 to promote high tuberculosis treatment completion rates. Methods. The Harlem program used an on-site surrogate family model. Treatment completion rate, visit adherence rate, human immunodeficiency virus seroprevalence, and time to sputum culture conversion were assessed. Results. Out of 145 enrolled patients with suspected and confirmed tuberculosis, 95 (92 confirmed and 3 suspected) continued treatment. The visit adherence rate was 91.1 ± 7.9%, with one patient (1%) lost to follow-up. Conclusion. High rates of treatment completion and visit adherence were achieved because of unique program characteristics. Thus, directly observed therapy is advocated as a means of ensuring treatment completion.