Perception of Patients and Health Workers about Directly Observed Treatment Short Course (DOTS) Program Implementation in AL-Anbar Governorate

2015 ◽  
Vol 12 (1) ◽  
2009 ◽  
Vol 17 (5) ◽  
pp. 689-694 ◽  
Author(s):  
Alba Idaly Muñoz Sanchez ◽  
Maria Rita Bertolozzi

This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of São Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the health-disease process including the treatment and life projects of patients with tuberculosis.


Author(s):  
Nursalim Nursalim ◽  
Mappeaty Nyorong ◽  
Asriwati Amirah

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.


2019 ◽  
Vol 7 (1) ◽  
pp. 47-52
Author(s):  
Subash Baral ◽  
Shraddha Adhikari

Tuberculosis (TB) is the most problematic and highly prevalent communicable disease affecting about one-third of the world’s population and debilitating pulmonary (PTB) infection today. In spite of all these efforts by the government of Nepal, many people still die every year and transferring the disease to the healthy person. The new approach for the effective treatment of tuberculosis has been introduced i.e. Community Based Directly Observed Treatment Short Course (CB-DOTS) which provides training to community health workers to increase awareness, detection, and treatment of TB and bring services directly to the homes of those at risk for infection and those who are infected. The aim of this study was to compare availability, accessibility, compliance and satisfaction between CB-DOTS service and health institution based DOTS (HI-DOTS) service among TB patients. A cross sectional study was carried out in Kaski and Tanahun district in 2014. Census was conducted for the TB patients who are registered during 6 months in the community based DOTS with same number and same time period, that had been enrolled in DOTS from health institution were chosen. The collected data was entered in EPI-DATA and analyzed by using the software SPSS-16. In HI-DOTS the average traveling time to get TB drugs is ≤ 30 minutes for 56.8 percent respondents and in CB-DOTS majority of the respondents; 90.9 percent have to travel ≤ 30 minutes. In HI-DOTS majority; 84.1 percent were dissatisfied and only 15.9 percent were satisfied. Just opposite to this, majority (81.8%) of respondents utilizing CB-DOTS service were satisfied and only 18.2 percent were dissatisfied. There is highly significant association between the patient's satisfaction and two different DOTS services (p<0.001). CB-DOTS service approach shows its better effectiveness in availability, accessibility, compliance and patient's satisfaction aspects. CB-DOTS is a viable option and can complement and strengthen the existing HI-DOTS, especially in developing countries like Nepal where the health system is overwhelmed with increasing number of TB patients and high TB related deaths. Key words: Community Based Directly Observed Treatment Short Course, Availability, Accessibility, Satisfaction


Publika ◽  
2021 ◽  
pp. 201-214
Author(s):  
Febry Mega Kumalasari ◽  
Indah Prabawati

Data Dinas kesehatan Kabupaten Mojokerto, jumlah penderita TBC positif sepanjang tahun 2018 mencapai 1.436 orang, dari jumlah itu 177 penderita dinyatakan sembuh dan 4 orang meninggal dunia. Puskesmas Bangsal melaksanakan kebijakan Directly Observed Treatment Short-course (DOTS) untuk penanggulangan penyakit TB berdasarkan Peraturan Menteri Kesehatan No. 67 Tahun 2016 tentang penanggulangan tuberkulosis. Penelitian ini bertujuan untuk menganalisis implementasi kebijakan penanggulangan tuberkulosis dengan strategi DOTS di Puskesmas Bangsal. Metode penelitian yang digunakan adalah kualitatif deskriptif menggunakan studi kepustakaan dan wawancara menggunakan teknik analisis Miles dan Huberman. Hasil penelitian pada implementasi kebijakan DOTS pada puskesmas Bangsal dalam lima ketepatan yaitu. Ketepatan Kebijakan sudah tepat, namun dalam pemecahan masalah masih kurang optimal pada kesadaran masyarakat dalam penghentian pengobatan sepihak jika sudah merasa sembuh oleh masyarakat dan ketakutan masyarakat terhadap ancaman virus COVID-19. Ketepatan pelaksanaan, pencapaian target strategi DOTS yang belum mencapai target karena dukungan pemerintah pada pendanaan untuk sosialisasi, penyuluhan dan promosi kesehatan terbatas. Ketepatan target belum optimal karena pada tahun 2020 Puskesmas Bangsal mendapatkan 43 kasus dan 250 orang yang diperiksa atausekitar 53% dari target yang telah ditetapkan. Ketepatan Lingkungan, komunikasi dengan Dinas Kesehatan belum optimal dalam monitoring dan evaluasi, pelaporan STIB. Ketepatan Proses, Puskesmas Bangsal mulai dari penemuan kasus, pengobatan hingga ke pelaporan sudah sesuai dengan SOP pelaksanaan kebijakan DOTS. Permasalahan yang terjadi adalah tenaga kesehatan kesulitan dalam melakukan pelaporan online (STIB). Saran yang dapat diberikan yaitu melakukan sosialisasi secara intensif. Dukungan pemerintah dalam menambah pendanaan untuk sosialisasi, penyuluhan dan promosi kesehatan. Meningkatkan koordinasi lintas sektoral dan memberikan pelatihan tentang tata cara pengisian SITB. Kata Kunci: Implementasi, Tuberculosis, Directly Observed Treatment Short-course (DOTS).   Mojokerto District Health Office data, the number of positive TBC patients throughout 2018 reached 1,436 people, of which 177 patients were declared cured and 4 people died. Puskesmas Bangsal implements a Policy of Directly Observed Treatment Short-course (DOTS) for TB disease management based on Regulation of the Minister of Health No. 67 of 2016 on tuberculosis prevention. This study aims to analyze the implementation of tuberculosis control policies with the DOTS strategy at Puskesmas Bangsal, Mojokerto Regency. The research method used  descriptive qualitative using literature study and interview with the analysis technique of Miles and Huberman. The results of research on the implementation of the DOTS policy at the Bangsal puskesmas were in five accuracy.The accuracy of the policy is right, but in managing the problemis not optimal in public awareness of treatment and the community's fear of the COVID-19. Accuracy of implementation, the DOTS target strategy has not yet reached the target due to the limited political commitment to budget funds for cadres, outreach, health education and promotion. The accuracy of the target is not optimal in 2020 the Puskesmas Bangsal received 43 cases and250 people were checked or about 53% of the target. Environmental accuracy, communication with the Dinas Kesehatan is not optimal in monitoring and evaluation, STIB reporting. Accuracy of Process, Puskesmas Bangsal starting from case finding, treatment to reporting are in accordance with the DOTS Policy. The problem is health workers have difficulty in conducting online reporting (STIB). The advice that can be given is to conduct intensive socialization. Government support in increasing funding for socialization, counseling, and health promotion. Improve cross-sectoral coordination and provide training on procedures for filling SITB application. Keywords: Implementation, Tuberculosis, Directly Observed Treatment Short-course (DOTS).


2021 ◽  
Vol 9 ◽  
pp. 205031212198949
Author(s):  
Cylia Nkechi Iweama ◽  
Olaoluwa Samson Agbaje ◽  
Prince Christian Ifeanachor Umoke ◽  
Chima Charles Igbokwe ◽  
Eyuche Lawretta Ozoemena ◽  
...  

Introduction: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. Methods: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05) Results: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence. Conclusion: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.


Author(s):  
A. Divya ◽  
Dhaval P. Shukla ◽  
Veenakumari H. Bahubali ◽  
Rose Dawn Bharath ◽  
B.N. Nandeesh ◽  
...  

Author(s):  
Masoud Behzadifar ◽  
Masoud Mirzaei ◽  
Meysam Behzadifar ◽  
Abouzar Keshavarzi ◽  
Maryam Behzadifar ◽  
...  

2017 ◽  
Vol 10 (1) ◽  
pp. 19
Author(s):  
Diah Hermayanti

Latar belakang : Pengendalian TBC di Indonesia, dilaksanakan dengan strategi Directly Observed Treatment Short Course (DOTS). Prinsip pengobatan TBC strategi DOTS menggunakan obat anti tuberkulosa (OAT) yang diberikan dalam bentuk kombinasi dari beberapa jenis, dalam jumlah cukup, dan dosis tepat selama 6 – 8 bulan. Penderita dikategorikkan sebagai kasus konversi BTA negatif bila dalam pemeriksaan ulangan BTA masih dijumpai kuman BTA positif dalam sputumnya.Tujuan : mengeksplorasi lebih lanjut faktor-faktor yang diduga dapat menyebabkan terjadinya konversi BTA negatif pada akhirmasa intensif pengobatan dan pada penderita dengan kategori gagal. Metode : Penelitian deskriptif observasional dengan pendekatan studi cross sectional, yang dilakukan di Poli Puskesmas Kedung Kandang Malang. Hasil penelitian : didapatkan 4 penderita yang masuk kriteria konversi BTA negatif dengan pendidikan 75% SD dan 25% SMP; status gizi berdasarkan IMT 75% termasuk kriteria kurus; 100% taat berobat; dan pada semua pemeriksaan kultur sputum tidak dijumpai pertumbuhan kuman. Kesimpulan : Status sosial ekonomi dan status gizi penderita TBC dengan konversi BTA negatif adalah rendah, namun kepatuhannya berobat cukup tinggi. Resistensi kuman TBC terhadap OAT program jangka pendek pada penelitian tidak dapat dievaluasi oleh karena tidak ada pertumbuhan kuman pada semua sampel sputum penderita.Kata kunci : DOTS, OAT, BTA, Konversi negative


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