Evaluating Sputum Conversion Rates for Pulmonary Tuberculosis Using a Comparative Video-Based Dots and Standard Dots: A Clinical Control Trial

Background: The sputum smear test is a key tool in diagnosing and monitoring treatment response in pulmonary tuberculosis (PTB). Despite the implementation of directly observed therapy short course (DOTS), sputum conversion rates have not improved significantly. This highlights the need for enhanced supervision and monitoring, particularly for patients located far from healthcare providers. This study aimed to evaluate the impact of intensive home monitoring of anti-TB drug adherence through telemedicine, specifically using video directly observed therapy (ViDOT). Methodology: This clinical control trial (CCT) involved participants assigned to either the ViDOT or standard DOTS group in a 1:1 ratio. Patients were consecutively recruited in a non-randomized manner and followed for six months. To minimize performance bias, the control group was unaware of the study and did not have access to the monitoring app. Results: A total of 150 patients participated, with ages ranging from 18 to 60 years, and males representing 54% of the cohort. Seventy-two percent of the cases were new TB diagnoses, with the highest prevalence observed in patients aged 31 to 40 years (39.33%), predominantly among those holding a Bachelor’s degree (32.67%). Among patients receiving ViDOT and DOTS, only the presence of comorbidities and adherence to medication significantly affected sputum conversion (P < 0.001). A notable decline in the number of patients without sputum conversion was observed in the ViDOT group, while an increase was noted in the DOTS group. Conclusion: Patients utilizing telemedicine-based DOTS exhibited a higher likelihood of successful sputum conversion by the end of the treatment period compared to those receiving standard DOTS. It is recommended that healthcare systems should consider integrating ViDOT into their existing infrastructure to enhance the monitoring and supervision of anti-TB treatment, ultimately improving sputum conversion rates and treatment outcomes.