CHReaD Engagement at the East African Health Scientific Conference

In November 2021, we held a scientific conference to present an abstract on Facility-based directly observed therapy (DOT) for tuberculosis during COVID-19: a community perspective. The oral abstract presented by Rahab Mwaniki Campaigns Manager, KANCO, highlighted quantitative and qualitative findings from a global community-based survey on the challenges of administering facility-based DOT during the pandemic as well as potential alternatives.

Facility-based DOT has been the standard for treating people with TB since the early 1990s. As the commitment to promote a people-centered model of care for TB grows, the use of facility-based DOT has been questioned as issues of freedom, privacy, and human rights have been raised. The disruptions caused by the Covid-19 pandemic and ensuing lockdown measures have fast-tracked the need to find alternative methods to treat people with TB.

The research found that decreased access to transportation, the fear of COVID-19, stigmatization due to overlapping symptoms, and punitive measures against quarantine violations have made it difficult for persons with tuberculosis (TB) to receive treatment at facilities, particularly in low-resource settings. Potential replacements included greater focus on community-based DOT, home delivery of treatment, multi-month dispensing, and video DOT strategies.