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Does directly observed therapy improve tuberculosis treatment? More evidence is needed to guide tuberculosis policy

Overview of attention for article published in BMC Infectious Diseases, October 2016
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (67th percentile)
  • Good Attention Score compared to outputs of the same age and source (70th percentile)

Mentioned by

policy
1 policy source
twitter
2 X users

Citations

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35 Dimensions

Readers on

mendeley
178 Mendeley
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Title
Does directly observed therapy improve tuberculosis treatment? More evidence is needed to guide tuberculosis policy
Published in
BMC Infectious Diseases, October 2016
DOI 10.1186/s12879-016-1862-y
Pubmed ID
Authors

Zoë M. McLaren, Amanda A. Milliken, Amanda J. Meyer, Alana R. Sharp

Abstract

Tuberculosis (TB) now ranks alongside HIV as the leading infectious disease cause of death worldwide and incurs a global economic burden of over $12 billion annually. Directly observed therapy (DOT) recommends that TB patients complete the course of treatment under direct observation of a treatment supporter who is trained and overseen by health services to ensure that patients take their drugs as scheduled. Though the current WHO End TB Strategy does not mention DOT, only "supportive treatment supervision by treatment partners", many TB programs still use it despite the fact that the has not been demonstrated to be statistically significantly superior to self-administered treatment in ensuring treatment success or cure. DOT is designed to promote proper adherence to the full course of drug therapy in order to improve patient outcomes and prevent the development of drug resistance. Yet over 8 billion dollars is spent on TB treatment each year and thousands undergo DOT for all or part of their course of treatment, despite the absence of rigorous evidence supporting the superior effectiveness of DOT over self-administration for achieving drug susceptible TB (DS-TB) cure. Moreover, the DOT component burdens patients with financial and opportunity costs, and the potential for intensified stigma. To rigorously evaluate the effectiveness of DOT and identify the essential contributors to both successful treatment and minimized patient burden, we call for a pragmatic experimental trial conducted in real-world program settings, the gold standard for evidence-based health policy decisions. It is time to invest in the rigorous evaluation of DOT and reevaluate the DOT requirement for TB treatment worldwide. Rigorously evaluating the choice of treatment supporter, the frequency of health care worker contact and the development of new educational materials in a real-world setting would build the evidence base to inform the optimal design of TB treatment protocol. Implementing a more patient-centered approach may be a wise reallocation of resources to raise TB cure rates, prevent relapse, and minimize the emergence of drug resistance. Maintaining the status quo in the absence of rigorous supportive evidence may diminish the effectiveness of TB control policies in the long run.

X Demographics

X Demographics

The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 178 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Mozambique 1 <1%
United States 1 <1%
Unknown 176 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 28 16%
Student > Bachelor 26 15%
Student > Ph. D. Student 22 12%
Researcher 18 10%
Student > Postgraduate 13 7%
Other 26 15%
Unknown 45 25%
Readers by discipline Count As %
Medicine and Dentistry 37 21%
Nursing and Health Professions 33 19%
Social Sciences 11 6%
Pharmacology, Toxicology and Pharmaceutical Science 8 4%
Economics, Econometrics and Finance 6 3%
Other 29 16%
Unknown 54 30%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 May 2020.
All research outputs
#7,174,980
of 23,881,329 outputs
Outputs from BMC Infectious Diseases
#2,260
of 7,931 outputs
Outputs of similar age
#105,025
of 322,603 outputs
Outputs of similar age from BMC Infectious Diseases
#63
of 220 outputs
Altmetric has tracked 23,881,329 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 7,931 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 322,603 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 220 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.