Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113097

Tom Mohr, Robert Northrup, PhD, and Katrina Erdahl, MPH. Project HOPE, 255 Carter Hall Lane, Millwood, VA 22646, 540-837-9576, kerdahl@projecthope.org

Incentives, particularly food, are used in many DOTS programs to facilitate tuberculosis treatment compliance and completion. The purpose of this program is to determine the effect of a food supplement incentives program on treatment outcomes in the Tajikistan DOTS program.

The food enabler and incentive component of the Tajikistan DOTS program began in December 2002, and targets the most vulnerable patients with tuberculosis. Over 800 patients participated in the program, and treatment outcomes are available for over 340 food supplement recipients. Treatment outcomes for vulnerable patients enrolled in the food supplement program were compared with treatment outcomes for patients that did not qualify for the program.

When comparing the two groups, the treatment outcomes are better for the vulnerable patients that received food supplements, than for the patients that did not receive supplements. Among new smear positive patients, this includes higher cure rates (86% vs. 60%), lower percentages of treatment failures (10.7% vs. 16%), lower percentages of patients that died (2% vs. 12%) and substantially lower default rates (1% vs. 12%). The disparity in cure rates between new smear negative patients and patients with extra-pulmonary tuberculosis was even greater; favoring those enrolled in the food supplement program.

In conclusion, the food supplement incentive made a major contribution to the success of the DOTS program. The results indicate that food supplements and other enablers and incentives should be considered for all patients enrolled in DOTS treatment in Tajikistan.

Learning Objectives: At the conclusion of this presentation, the participants in this session will be able to

• Describe an appropriate setting for food support programs,
• Discuss the positive and negative aspects of including enablers/incentives in programs involving patient compliance issues, and
• Explain the importance of patient compliance in a TB DOTS program.

Keywords: Tuberculosis, Treatment Outcomes

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation