Tuberculosis in the community .1. Evaluation of a volunteer health worker programme to enhance adherence to anti-tuberculosis treatment

Setting: A voluntary health worker project (Operation Elsies River) was started in a high incidence tuberculosis (TB) area in the Western Cape of South Africa, in order to assist the local TB Control programme with case-holding. Objective: To evaluate the effectiveness of this group of volunteers in enhancing adherence of notified TB patients to tuberculosis treatment. Design: A cohort study was conducted with 351 TB patients (203 children and 148 adults). Results: The data from the child and the adult groups were analysed separately, The child group was more adherent to TB treatment than adults, The supervision option with staff dedicated to the treatment of TB, such as the clinic and the SANTA creche, achieved better adherence results for pre-school children, The supervision modalities for adults did not differ in their adherence performance even following adjustment for confounders. Conclusion: The supervision option provided by the volunteers did not significantly improve the adherence of adult patients to antituberculosis treatment.