ABSTRACT
In Togo, the COVID-19 pandemic paved the way for decentralising directly observed treatment (DOT) to the community level through the evaluation of two innovative community-based DOT approaches-a community health worker-based (CHW-DOT) and family-based (FB-DOT). METHODS We conducted an observational prospective study from April 2021 to January 2022. Sputum conversion at Month 2 and favourable treatment outcomes at Month 6 were assessed and compared between the two groups. Sociodemographic and clinical factors related to these outcomes were identified. RESULTS A total of 182 TB patients were enrolled. The CHW-DOT group had significantly increased odds of sputum conversion (aOR 2.95, 95% CI 1.09-7.98) and lower odds of unsuccessful treatment outcomes (aOR 0.37, 95% CI 0.13-1.1). Non-smokers had 4.85 higher odds of converting than smokers (aOR 4.85, 95% CI 1.76-13.42) and lower odds of an unsuccessful treatment than smokers (aOR 0.11, 95% CI 0.04-0.32). CONCLUSION CHW-DOT is associated with higher sputum smear conversion rates and a more favourable treatment outcome. The use of tobacco, significantly associated with outcomes, also suggests that a smoking cessation component may be a valuable adjunct to a CHW-DOT approach during TB treatment..
Subject(s)
Tuberculosis , Humans , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Prospective Studies , Togo/epidemiology , Pandemics , Treatment Outcome , Health Facilities , Antitubercular Agents/therapeutic useABSTRACT
De janvier 1984 a juin 1986 une enquete prospective concernant 15.782 naissances a ete menee en vue d'etudier la mort foetale in-utero a la maternite du CHU de Lome. 308 cas ont ete enregistres. Le mode de recrutement a ete decrit. Pour chaque variable; le risque relatif a ete calcule pour un intervalle de confiance de 95 pour cent. Les differentes proportions observees ont ete soumises au test de X2 avec un degre de signification a 5 pour cent et 1 pour cent selon qu'il s'agit d'une variable ou d'un groupe de variables. Le risque de mortinatalite est plus eleve dans le groupe de femmes de conditions socio-economique et socio-culturelle defavorisees. Ce risque diminue avec l'amelioration de ces conditions. L'interet de ce travail a ete souligne
