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Table 1 Summary of Findings: Community-based treatment compared with traditional hospitalization for MDR-TB and XDR-TB patients

From: Community-based management versus traditional hospitalization in treatment of drug-resistant tuberculosis: a systematic review and meta-analysis

Author, Year, Country of Study, Study period

Arm, N, Percent Female, Age

Intervention Components

Intervention setting, Intervention provider, Length of DOTS

Drug model, number of drugs, treatment duration (intensive, continuation phase), Proportion previously treated

Brust JC 2012 [12]

Prospective cohort

South Africa

2008–2010

Community-based intervention N = 80 Female: 63 %

Age: 34 HIV+: 83 %

Extensive training of PHC staff, Routine home visits, Clinician support, DOTS supervised by healthcare worker, DOTS supervised by family treatment supporter, DOTS supervised by a healthcare worker, Education of patients and family treatment supporter, Adherence support and adverse event monitoring, Mobile multidisciplinary teams of home care providers & HIV treatment

Decentralized, outpatient

Friends/relatives staying close by, Home care support, DOTS nurse, Community Health Extension Worker (CHEW)

Throughout therapy

Standardized 6, NR 6, 24 NR

Brust JC 2010 [39]

Retrospective cohort

South Africa

2000–2003

Traditional hospitalization N = 1209 Female: 39 %

Age: 33 HIV+: 52 %

Hospitalization

Hospital

No DOTS provider

Partial Observation

Standardized

5,4 4-6, 18 NR

Cox H 2007 [41]

Retrospective cohort

Uzbekistan

2003–2005

Traditional Hospitalization

N = 87

Female: 39.1 %

Age: 31

HIV+: NR

Hospitalization

Hospital

Trained facility based healthcare worker

NR

Individualized

6, NR 6,18 100 %

Cox H 2014 [30]

Retrospective cohort

South Africa

2005–2011

Community-based intervention N = 1208 Female: 50 %

Age: 33 HIV+: 70 %

Extensive training of primary health care center (PHC) staff, Routine home visits, Clinician support, Social assistance and support groups, DOTSa supervised by healthcare worker

PHC

Trained facility based healthcare worker

Throughout therapy

Standardized 5, NR b

6, 18 NR

Hirpa S 2013 [42]

Case control study

Ethiopia

2011–2012

Traditional Hospitalization

N = 134

Female: 39.5 %

Age: 25.1

HIV+: 13.4 %

Clinician support

Healthcare workers

Hospital

Trained facility based healthcare worker

Partial observation

Standardized

5, NR

NR, NR

NR, NR

Joseph P 2011 [33]

Prospective cohort

India

2006–2007

Community-based intervention N = 38 Female: 34.2 %

Age: NR HIV+: NR

Extensive training of PHC center staff, Routine home visits, education of patients and family treatment supporter, Supply of drugs to local health center

NR

Trained facility based healthcare worker, Friends/relatives staying close by, Private medical practitioners

Throughout therapy

Standardized

6,4 6–9, 18 NR

Keshavjee S 2008 [38]

Retrospective cohort

Russia

2000–2004

Traditional Hospitalization

N = 608 Female: NR

Age: 33.9 HIV+: NR

Hospitalization and DOTS supervised by healthcare worker

Hospital

DOTS supervised by healthcare worker

Partial Observation

Individualized 5, 5

6–9, 18 100 %

Liu CH 2011 [37]

Retrospective cohort

China

1996–2009

Traditional Hospitalization

N = 576 Female: 33.9 %

Age: 41 HIV+: NR

Clinician support

Hospital

NR

NR

Individualized 5, NR c

18, 18 68.7 %

Vaghela JF 2015 [14]

Prospective cohort

India

2009–2012

Community-based intervention N = 101 Female: 40.6 %

Age: 33 HIV+: NR

Extensive training of primary health care center staff, Physical and mental support Counseling, Routine home visits, Adherence support and adverse event monitoring, Mobile multidisciplinary teams of home care providers, Vocational rehabilitation, Hygiene & Nutrition counseling, Nursing care, Financial rehabilitation

PHC, Patient home

Trained facility based healthcare worker, Home care support

Throughout therapy

NR NR, NR 6, 24–27 NR

Oyieng’o D 2012 [11]

Retrospective cohort

Kenya

2008–2010

Community-based intervention N = 14 Female: 50 %

Age: NR HIV+: 50 %

Extensive training of PHC staff, Routine home visits, Clinician support, DOTS supervised by family treatment supporter, DOTS supervised by healthcare worker, Education of patients and family treatment supporter, Adherence support and adverse event monitoring, Mobile multidisciplinary teams of home care providers

Decentralized, Local Health Centre

Friends/relatives staying close by, Home care support, DOTS nurse, CHEW

Throughout therapy

Standardized

5,4 6, 18 NR

Singla R 2009 [34]

Retrospective cohort

India

2002–2006

Community-based intervention N = 126 Female: 42 %

Age: 26 HIV+: NR

DOTS supervised by family treatment supporter, Daily supervised treatment in peripheral health centers, decentralized care

Decentralized

Friends and family staying close by

Throughout therapy

Standardized

5,3 6–9, 18 NR

Shin SS 2007 [40]

Retrospective cohort

Russia

2000–2002

Traditional Hospitalization

N = 244 Female: 9.2 %

Age: 31 HIV+: NR

Hospitalization and trained facility based healthcare worker

Trained facility based healthcare worker

Throughout therapy

Individualized NR, NR

18.5, 18 100 %

Tupasi TE 2006 [31]

Retrospective cohort

Philippines

1999–2002

Community-based intervention N = 117 Female: 26 %

Age: 38 HIV+: NR

DOTS supervised by healthcare worker, Daily supervised treatment in peripheral health centers, Home based DOTS

PHC, Patient home

Trained facility based healthcare worker

Partial Observation

Individualized

NR, NR 6, 18 18.8 %

Thomas A 2007 [32]

Prospective cohort

India

1999–2003

Community-based intervention N = 66 Female: 30.3 %

Age: 38 HIV+: NR

Routine home visits, Clinician support, DOTS supervised by healthcare worker, Financial rehabilitation

PHC, Patient home

Trained facility based healthcare worker, Village health worker, private provider

Partial Observation

Individualized

5,NR 6–9, 12 100 %

Van Deun A 2010 [36]

Prospective cohort

Bangladesh

1997–2007

Traditional hospitalization N = 427 Female: 25.5 %

Age: 31.7 HIV+: NR

Clinician support

Hospital

Trained facility based healthcare worker

NR

Standardized

NR, NR NR, NR 100 %

Wei X 2015 [35]

Retrospective cohort

Ethiopia

2990–2102

Community- based intervention

N: 110

Female: 26.4 %

HIV+: Yes (NR)

Routine home visits, DOTS supervised by healthcare worker and family

PHC, Patient home

Village health worker, family

Throughout therapy

Standardized

5, NR 6, 18 NR

  1. aDOTS, Directly observed therapy short course
  2. b NR Not reported
  3. c NR Not reported