Evaluation of four-years hospital implementation of DOTS strategy (1998 - 2002).

ABSTRACT

AIM: To obtain an overview of the problem and to know the success and result of DOTS method in tuberculosis treatment. METHODS: Application of DOTS at the hospital was done every Monday during working hours at the outpatient clinic pulmonology clinic Department of Internal Medicine of Dr. Mohammad Hoesin Hospital in Palembang, Indonesia. Selection of patients was done at the general outpatient clinic. Patients suspected with pulmonary TB were clinically investigated with the sputum Acid Fast Bacilli 3x test (spot, morning, spot). If the sputum tests were negative, the patients underwent Chest X Ray. Patients with complete data were referred to the DOTS clinic. Hospital nurses and doctor residents from internal medicine filled up the medical records, TB form and registration of identity card, determined the Observer of Medicine Consumption (PMO) and provided the "Informed Consent". Education and motivation on the problem of tuberculosis were conducted by doctors and nurses. Finally, patients are requested to consume medicine by their observer with assistance from the pharmacist, and were given DOTS medicine for 1 - 2 weeks. RESULTS: At the end of August 2002, 517 patients had completed treatment. The cure rate from positive sputum AFB was 82.17% (295 from 359 patients); 87.7% for category I (221 from 252 patients) and 69.2% for category II (74 from 107 patients). This can be increased to 85.3.% (295/344; Total), 92.5% (221/239 ; category I) and 70.5% (74/105; category II), those patients transfered out were not included in the denomination. The percentage of those who completed category III treatment was 91.8% (145 from 158 patients), with a drop - out/default rate of 6.2%. CONCLUSION: DOTS strategy in hospital was done by DOTS team consisted of doctors, nurses, assistant pharmacist and health workers. The number of TB cases in Moh. Hoesin Hospital Palembang in category I is more than category II/III, RK Charitas Category III is more than category I/II which are unemployed, primary school and productive ages. DOTS treatment on 2006 was done by FDC (Fixed Dose Combination).