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1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022

BACKGROUND: Tuberculosis (TB) is an infectious disease with a high burden of morbidity and mortality, potentially curable in up to 85% of cases with first-line treatment, when adherence is over 90%. Direct observed treatment (DOTS) guarantees treatment adherence. However, barriers such as the time a...

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Autores principales: García-Goez, José Fernando, Montes-Tello, Sofía Alexandra, Rios-Pineda, David A, Uribe-Romero, Esteban, Rojas-Ramirez, Mayra A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679211/
http://dx.doi.org/10.1093/ofid/ofad500.1704
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author García-Goez, José Fernando
Montes-Tello, Sofía Alexandra
Rios-Pineda, David A
Uribe-Romero, Esteban
Rojas-Ramirez, Mayra A
author_facet García-Goez, José Fernando
Montes-Tello, Sofía Alexandra
Rios-Pineda, David A
Uribe-Romero, Esteban
Rojas-Ramirez, Mayra A
author_sort García-Goez, José Fernando
collection PubMed
description BACKGROUND: Tuberculosis (TB) is an infectious disease with a high burden of morbidity and mortality, potentially curable in up to 85% of cases with first-line treatment, when adherence is over 90%. Direct observed treatment (DOTS) guarantees treatment adherence. However, barriers such as the time and cost of travel to the supply site, social stigma have weakened its efficiency. As an alternative, video monitoring of tuberculosis treatment (VDOT), had been evaluated with favorable results compared to DOTS, making it a promising strategy. [Figure: see text] METHODS: A quasi-experimental study was conducted in Cali, Colombia. Patients aged ≥ 18 years with TB sensitive to first-line drugs were included. Patients were allocated in synchronous VDOT, where remote and real-time video calls were daily, while in asynchronous VDOT, patients sent video messages of the daily dose intake using the WhatsApp app mobile application. The characteristics of both groups were described, and the comparison was made according to the intervention (VDOT) using Cox regression. RESULTS: A total of 133 were included, 66 in synchronous VDOT and 67 in asynchronous VDOT . The mean age was similar in both groups and, the 60% of the patients were male. Patients in the asynchronous VDOT group had more comorbidities. Pulmonary tuberculosis was the most frequent presentation in both groups. Treatment was completed in 43.9% in synchronous VDOT, and 28.3% in asynchronous VDOT. Loss to follow-up was higher in the asynchronous VDOT. Four deaths occurred in synchronous VDOT and one in asynchronous VDOT. The mean follow-up time was 198 days. Also, Cox regression showed that the synchronous strategy has 88% risk of completing antituberculosis treatment in less time than the asynchronous monitoring group, HR: 1.88 IC95%: 1.26 - 2.81, p= 0.002. CONCLUSION: Asynchronous VDOT seems to have a higher risk of desertion than synchronous VDOT, as opposed to literature finds. A relationship between comorbidities or risk factors that have not been evidenced in our study is not ruled out. Further studies are needed to compare the effectiveness of synchronous vs asynchronous VDOT in challenging scenarios, such as low income, poor internet connectivity, poor technology, and limited logistical capacity of the TB group. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-106792112023-11-27 1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022 García-Goez, José Fernando Montes-Tello, Sofía Alexandra Rios-Pineda, David A Uribe-Romero, Esteban Rojas-Ramirez, Mayra A Open Forum Infect Dis Abstract BACKGROUND: Tuberculosis (TB) is an infectious disease with a high burden of morbidity and mortality, potentially curable in up to 85% of cases with first-line treatment, when adherence is over 90%. Direct observed treatment (DOTS) guarantees treatment adherence. However, barriers such as the time and cost of travel to the supply site, social stigma have weakened its efficiency. As an alternative, video monitoring of tuberculosis treatment (VDOT), had been evaluated with favorable results compared to DOTS, making it a promising strategy. [Figure: see text] METHODS: A quasi-experimental study was conducted in Cali, Colombia. Patients aged ≥ 18 years with TB sensitive to first-line drugs were included. Patients were allocated in synchronous VDOT, where remote and real-time video calls were daily, while in asynchronous VDOT, patients sent video messages of the daily dose intake using the WhatsApp app mobile application. The characteristics of both groups were described, and the comparison was made according to the intervention (VDOT) using Cox regression. RESULTS: A total of 133 were included, 66 in synchronous VDOT and 67 in asynchronous VDOT . The mean age was similar in both groups and, the 60% of the patients were male. Patients in the asynchronous VDOT group had more comorbidities. Pulmonary tuberculosis was the most frequent presentation in both groups. Treatment was completed in 43.9% in synchronous VDOT, and 28.3% in asynchronous VDOT. Loss to follow-up was higher in the asynchronous VDOT. Four deaths occurred in synchronous VDOT and one in asynchronous VDOT. The mean follow-up time was 198 days. Also, Cox regression showed that the synchronous strategy has 88% risk of completing antituberculosis treatment in less time than the asynchronous monitoring group, HR: 1.88 IC95%: 1.26 - 2.81, p= 0.002. CONCLUSION: Asynchronous VDOT seems to have a higher risk of desertion than synchronous VDOT, as opposed to literature finds. A relationship between comorbidities or risk factors that have not been evidenced in our study is not ruled out. Further studies are needed to compare the effectiveness of synchronous vs asynchronous VDOT in challenging scenarios, such as low income, poor internet connectivity, poor technology, and limited logistical capacity of the TB group. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10679211/ http://dx.doi.org/10.1093/ofid/ofad500.1704 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
García-Goez, José Fernando
Montes-Tello, Sofía Alexandra
Rios-Pineda, David A
Uribe-Romero, Esteban
Rojas-Ramirez, Mayra A
1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022
title 1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022
title_full 1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022
title_fullStr 1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022
title_full_unstemmed 1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022
title_short 1876. Characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in Cali - Colombia during 2019-2022
title_sort 1876. characterization of patients with active drug-sensitive tuberculosis on synchronous and asynchronous video monitoring treatment in cali - colombia during 2019-2022
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679211/
http://dx.doi.org/10.1093/ofid/ofad500.1704
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