Cost – effectiveness of dots programme in tuberculosis treatment

The failure of old T.B. programme to achieve control, leads WHO to introduce DOTs as a new strategy for T.B. control. Health system research (HSR) aimed at the evaluation of effectiveness of the two strategies, is done by following two cohorts of patients; 112 patients on DOTs and 124 patients on old treatment regimen. Sputum smear conversion rate, cure rate and success rate were studied in a period of six months. The results showed that the age groups (15-44) years were mostly affected in both cohorts. Female to male ratio is 1:2.3 with mean age for males (33) years and (29) years for females. Sputum smear positive form (50) of the sample for those on DOTs and (57) for those on old regimen, with predominance of male to female (70%) and (30%) respectively. Higher rate of smear conversion was achieved after two months of treatment with DOTs (94%), than old regimen (70%). Success rate of treatment with DOTs was (94%) and old regimen (65%), defaulter rates were (6%) and (35%) respectively for the stratehies. Cost per case detection and follow-up in DOTs was (14) units. Cost per case detection and follow-up in old regimen was (23.5) units. Cost per case cured in DOTs ranged from (35.8) to (88.3) thousands ID according to category of patients. Cost per case cured in old regimen was (56.6) thousands ID. Compliance of patients with DOTs is much easier than those with the old regimen as many problems facing patients in old regiman were solved. A progressive adoption of DOTs all over Iraq in recommended.