Background: This paper summarises our experiences about the role of community DOT providers in management of TB
treatment in HIV infected persons in a mainly rural population of Tamilnadu.
Objectives: To evaluate the feasibility of employing Community DOT providers for the treatment of tuberculosis in HIV
infected persons, to study patients’ acceptance of Community DOT providers in the closely-knit village communities and
to find out the attitude and awareness of DOT Providers on TB and DOT.
Method: A total of 62 tuberculosis patients (58 males and 4 females) with HIV infection attending the Government Hospital
for Thoracic Medicine, Tambaram and Chennai between July 1999 and July 2002 were selected for this study. Patients were
given all the doses under supervision (clinic-based DOT) during the initial intensive phase and through Community DOT
providers in the continuation phase. Data was collected both from the patients and their DOT providers about their views
on DOT, advantages of DOTS, drug intake, treatment adherence, problems faced by the patients and their DOT Providers
in addition to the level of awareness of Community DOT Providers on tuberculosis and DOTS.
Results: Regarding treatment adherence, 95% of 62 patients had taken >75% of drugs and 39% had taken 100% drugs. DOT
was appreciated both by the patients and their DOTS Providers since it is cost-effective and patient-friendly.
Conclusions: Community contribution to TB care even among HIV infected population is feasible, affordable and costeffective.
There is a need for greater health education and training on tuberculosis and DOTS for community DOT
Providers