Objective: To evaluate the use of family members as supervisors of directly observed therapy (DOT) in patients with tuberculosis. Methods: This was a prospective descriptive study involving patients diagnosed with pulmonary tuberculosis. The sample comprised 98 patients. A standardized protocol was implemented in order to train the patient and their families. After the training, the patient was allowed to choose either a family member or a health care worker as a supervisor. Absolute and relative frequencies were used in descriptive data analysis. Results: A family member supervisor was chosen by 94 patients (96%). The cure rate was 99%. The partner was chosen by 49% of the patients, and other family members were chosen by 28%. The heath care team needed to take over DOT in 3% of the cases. Regular attendance at follow-up appointments was 67%. It was observed that 24% of the problems in this DOT model referred to the family supervisor forgetting to administer the medication or to the patient forgetting to take it; 39% of the patients forgot to take the medication for one day, and 31% forgot to take it for two days. There was change of supervisor in 9% of the sample, medication was lost by the patient sometime during treatment in 9%, and patient drug intolerance occurred in 8%. Conclusions: DOT supervised by a family member has proven an effective and low-cost technique. However, compliance is not due to one single factor but to the combination of strategies adopted: bus passes; educational measures and especially the individualized approach.Keywords: Directly observed therapy; Tuberculosis; Patient compliance. ResumoObjetivo: Avaliar a utilização de supervisores domiciliares para dose supervisionada do tratamento(DOT), em pacientes portadores de tuberculose. Métodos: Trata-se de um estudo descritivo prospectivo com amostra composta por pacientes com diagnóstico de tuberculose pulmonar. Participaram deste estudo 98 pacientes. Um protocolo de capacitação do paciente e sua família foi implementado. Após este treinamento, o paciente poderia escolher entre um supervisor domiciliar e um profissional de saúde. Os métodos de análise descritiva utilizados foram a freqüência absoluta e relativa. Resultados: Um supervisor familiar foi escolhido por 94 pacientes (96%). O percentual de cura foi de 99%. O parceiro foi escolhido por 49% e algum outro familiar o foi por 28% dos pacientes. A equipe de pesquisa precisou assumir o DOT em 3% dos casos. O comparecimento regular para a supervisão foi de 67%. Verificou-se que 24% dos problemas encontrados neste modelo de DOT referiram-se ao esquecimento em administrar ou tomar as medicações, por parte do supervisor e do paciente, respectivamente, sendo que 39% dos pacientes deixaram de tomar a medicação por um dia e 31% esqueceram-se de tomá-la por dois dias durante o tratamento. Houve troca de supervisor em 9% da amostra, perda de medicação pelo paciente em algum momento do tratamento em 9% e intolerância do paciente à medicação em 8%. Conclusões: O DOT supervisionado pelo fa...

This open comparative study for evaluating hypersensitivity to tuberculin among medical students (n=441), nursing students (n=178) and economics students (n=230) in Vitória, State of Espírito Santo, had the aim of assessing whether the prevalence of positive tuberculin tests among healthcare students could be used as a sentinel event for nosocomial transmission in localities with high endemicity. There was a significant change in the frequency of purified protein derivative reactivity in the nursing students (20. 3%) and medical students (18. 4%), in comparison with the economics students (6%) (p <0. 001). As expected, the medical and nursing students had more knowledge about tuberculosis than did the economics students (p <0. 001). Our data suggest that the incidence of Mycobacterium tuberculosis infection among nursing and medical students in our region, which has high endemicity of tuberculosis, does not differ from what is found in low-incidence countries. These data reinforce the need for implementing biosafety programs for this target population.