This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

C. Patrick Chaulk, MD, MPH; Richard E. Chaisson, MD
The Johns Hopkins Medical Institutions

John N. Lewis, MD, MPH; Rosetta T. Rizzo, RN, MMS
Baltimore City Health Department Baltimore, Md

JAMA. 1994;271(2):103-104.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The recent article by Mahmoudi and Iseman¹ highlights avoidable pitfalls in the care of patients with Mycobacterium tuberculosis. In particular, we would like to underscore their recommendation for greater commitment to TB control programs such as those involving directly observed therapy (DOT).

The authors recommend, among other things, that "directly observed therapy should be provided in situations when noncompliance is demonstrated or deemed likely." However, since many studies suggest that predicting a patient's potential for compliance with therapy is itself fraught with difficulties, and since DOT is a proven strategy for TB management,² we recommend implementing DOT more broadly throughout the community. The impact of such a strategy can be demonstrated in the city of Baltimore, Md.

Between 1965 and 1978, Baltimore consistently ranked among the first three major US cities in the incidence of TB. In 1978, Baltimore began a clinic-based DOT program for . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?