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A Community-Based Tuberculosis Program in Cambodia
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To the Editor: Cambodia has one of the highest global burdens of tuberculosis (TB).1 In 1994, the Cambodian Health Committee (CHC), a nongovernmental organization, developed a community-based approach to the treatment of TB using microfinance and food supplementation in Svay Rieng, one of Cambodia's poorest provinces.
Methods
The program comprised 2 components: a health center–based component (hospital/health care center [HHC]) and a home-based component (Home Directly Observed Therapy Short Course [Home DOTS]). The mean annual target population was 149 577 for the HHC component and 11 557 for the Home DOTS component. Between 1994 and 2001, 2780 patients with TB were treated in the HHC protocol involving DOTS (with 2 months of forced hospitalization during the period 1994-1999, per the national protocol), followed by 6 months of outpatient therapy with monthly drug pick-up at the HHC. After 1999, daily health center visits were offered as an alternative to hospitalization during the intensive phase. . . . [Full Text of this Article]
Sok Thim;
Sun Sath;
Meas Sina
Cambodian Health Committee
Phnom Penh
Eunice Y. Tsai, MD;
Julio C. Delgado, MD;
Adrienne E. Shapiro, MSc
CBR Institute for Biomedical Research
Harvard Medical School
Boston, Mass
Clifton E. Barry III, PhD
TB Research Section
National Institute of Allergy and Infectious Diseases, National Institutes of Health
Rockville, Md
Philippe Glaziou, MD
Institut Pasteur du Cambodge
Phnom Penh
Anne E. Goldfeld, MD
goldfeld@cbr.med.harvard.edu
Cambodian Health Committee
Phnom Penh
CBR Institute for Biomedical Research
Harvard Medical School
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