Comparison of Tuberculosis Treatment Outcomes by Method of Treatment Supervision in the Fiji Islands

Setting: The National Tuberculosis Programme (NTP) in Fiji.Objective: To determine anti-tuberculosis treatment outcomes stratified by method of treatment supervision (i.e., self-administered treatment [SAT] vs. supervision by a family member).Design: A retrospective descriptive study of all tuberculosis (TB) patients registered with the NTP in Fiji between January 2011 and June 2013.Results: Of 563 TB patients registered, information on the type of treatment supervisor was available for 470 (83%). Of these, most (n = 401, 85%) had their treatment supervised by a family member, while 69 (15%) elected SAT. SAT patients had a treatment success rate of 79.4% compared to 88.5% in those supervised by a family member; the difference was statistically significant (P = 0.0374).Conclusion: Anti-tuberculosis treatment outcomes were more likely to be successful in patients who were supervised by a family member than in SAT patients. As this method of treatment supervision is not likely to be resource-intensive, we recommend that it continue in Fiji. Further prospective operational research could be carried out to determine patient preferences for anti-tuberculosis treatment supervision in Fiji, to promote a patient-centred approach.