Health managers and professionals experiences with tuberculosis treatment adherence in in-person and digital strategies
1
1.University of São Paulo, Ribeirão Preto, Brazil
2
2.São Paulo State Department of Health, Ribeirão Preto, Brazil
3
3.Salesian University Center of São Paulo, Americana, Brazil
4
4.State University of Western Paraná, Foz do Iguaçu, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Tuberculosis (TB) remains a major global public health priority, accounting for approximately 10.7 million new cases and 1.3 million deaths annually worldwide, and continues to be the leading cause of death from preventable infectious diseases(1) . Although TB incidence and mortality have declined, progress has been slow(1). The large reservoir of latent TB infection and the impact of the COVID-19 pandemic sustain high risk, making global targets difficult to achieve without intensified diagnosis, treatment, and prevention(1). Conventional Directly Observed Therapy (DOT) is widely used to support treatment adherence but requires substantial workforce investment and complex territorial logistics(2-4). Telehealth strategies, such as Video Directly Observed Therapy (vDOT), have been introduced to expand treatment monitoring(5). This study analyzed the experiences of health managers and professionals regarding TB treatment adherence under in-person and digital strategies.
METHODS:
A qualitative case study was conducted in specialized TB care services in a medium-sized Brazilian municipality, guided by the theoretical framework of treatment adherence(6). Semi-structured interviews were carried out with health managers and professionals involved in TB care. Interviews were transcribed and analyzed using deductive thematic analysis, supported by ATLAS.ti software, in accordance with ethical principles for health research.
RESULTS:
Nineteen professionals participated, including managers, physicians, nurses, and nursing technicians. Adherence was understood as a multifactorial process influenced by service organization, professional practices, and patients’ social conditions. Conventional DOT was associated with closer in-person follow-up but also with workforce overload and territorial barriers. vDOT facilitated adherence by increasing flexibility, reducing travel requirements, and promoting patient autonomy, although its effectiveness depends on access to digital technologies and institutional support.
CONCLUSIONS:
Conventional DOT and vDOT show complementary potential to strengthen TB treatment adherence. Implementation should consider patient profiles, access to digital technologies, and social vulnerability, reinforcing the importance of flexible, effective, and equitable public health care models.
Tuberculosis (TB) remains a major global public health priority, accounting for approximately 10.7 million new cases and 1.3 million deaths annually worldwide, and continues to be the leading cause of death from preventable infectious diseases(1) . Although TB incidence and mortality have declined, progress has been slow(1). The large reservoir of latent TB infection and the impact of the COVID-19 pandemic sustain high risk, making global targets difficult to achieve without intensified diagnosis, treatment, and prevention(1). Conventional Directly Observed Therapy (DOT) is widely used to support treatment adherence but requires substantial workforce investment and complex territorial logistics(2-4). Telehealth strategies, such as Video Directly Observed Therapy (vDOT), have been introduced to expand treatment monitoring(5). This study analyzed the experiences of health managers and professionals regarding TB treatment adherence under in-person and digital strategies.
METHODS:
A qualitative case study was conducted in specialized TB care services in a medium-sized Brazilian municipality, guided by the theoretical framework of treatment adherence(6). Semi-structured interviews were carried out with health managers and professionals involved in TB care. Interviews were transcribed and analyzed using deductive thematic analysis, supported by ATLAS.ti software, in accordance with ethical principles for health research.
RESULTS:
Nineteen professionals participated, including managers, physicians, nurses, and nursing technicians. Adherence was understood as a multifactorial process influenced by service organization, professional practices, and patients’ social conditions. Conventional DOT was associated with closer in-person follow-up but also with workforce overload and territorial barriers. vDOT facilitated adherence by increasing flexibility, reducing travel requirements, and promoting patient autonomy, although its effectiveness depends on access to digital technologies and institutional support.
CONCLUSIONS:
Conventional DOT and vDOT show complementary potential to strengthen TB treatment adherence. Implementation should consider patient profiles, access to digital technologies, and social vulnerability, reinforcing the importance of flexible, effective, and equitable public health care models.
| eISSN: | 2654-1459 |
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