Outcome of directly observed therapy for tuberculosis in Yokohama City, Japan

Yokohama City is currently developing directly observed treatment (DOT) in its programme, and requires guidance on types of DOT appropriate for local conditions.To assess the effectiveness of DOT for tuberculosis treatment in a retrospective study under operational conditions in Yokohama City.We included 80 patients with sputum-positive tuberculosis, 39 enrolled in DOT and 41 self-administered patients. The study was done at the National Hospital for Chest Diseases and the Community Clinic, which provide tuberculosis services with a standard daily short-course regimen. The main outcome measures were cure and treatment completion.The cure or treatment completion rate for the DOT and self-administered groups were respectively 87.2% and 68.3%. In a multivariate logistic regression model, cure or treatment completion was significantly associated with out-patient DOT (OR 4.04, 95%CI 1.22-13.33, P = 0.022).DOT was shown to be significantly superior to the self-administered regimen. However, our results were from an impoverished population with city-sponsored apartments and supplementary benefits. Further research will be needed to know the effectiveness of DOT in the general population.