SETTING: A large urban tuberculosis (TB) control program. OBJECTIVES: To identify factors associated with directly observed therapy (DOT) participation and to quantify how early use of DOT affected treatment duration. DESIGN: A retrospective study of 731 Asian-born patients with drug-susceptible Mycobacterium tuberculosis isolates who were verified in New York City between 1993 and 1997 and completed treatment. RESULTS: Overall, 297 (41%) of 731 patients in the study participated in DOT for some or all of their TB treatment. DOT participation was significantly associated with TB disease in a pulmonary site (adjusted odds ratio [aOR] 2.85, 95%CI 1.86-4.35), more recent year of diagnosis (aOR 1.70, 95%CI 1.50-1.94) and male sex (aOR 1.86, 95%CI 1.30-2.66). Patients who received ≥70% of their TB treatment at a health department chest clinic were also significantly more likely to participate in DOT (aOR 3.83, 95%CI 2.55-5.74). Among 297 DOT patients, those who completed treatment by 9 months received a greater amount of treatment by DOT during the first 4 months of treatment than those who took longer to complete treatment. CONCLUSION: Earlier DOT participation can lead to overall shorter treatment duration. Health care providers should encourage TB patients to participate in DOT as early as possible in their TB treatment. © 2005 The Union.

Asian immigrants tuberculosis Treatment completion Directly observed therapy

immigrant Asian human sex difference middle aged Asia controlled study Mycobacterium tuberculosis priority journal Aged United States school child Humans lung tuberculosis Adolescent Antitubercular Agents male tuberculostatic agent Tuberculosis, Pulmonary female Aged, 80 and over tuberculosis Article Retrospective Studies patient compliance major clinical study adult isoniazid New York City antibiotic sensitivity Emigration and Immigration Directly Observed Therapy retrospective study rifampicin Child