Video observed treatment for tuberculosis in people‑centred primary care: a narrative review of effectiveness, acceptability and mitigation of TB‑related catastrophic costs
1
Ribeirão Preto College of Nursing (EERP USP), University of São Paulo, Ribeirão Preto-SP, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Tuberculosis remains world leader in mortality by infectious diseases, causing almost 1.3 million deaths annually. Socially marginalized populations are disproportionately affected, highlighting inequities in diagnosis and care. Recommended by World Health Organization, the directly observed video treatment (vDOT) is a digital health strategy focus on the person, that strengthens adherence, teleassistance access, and Primary Health Care (PHC) centrality in tuberculosis management. Evidences of implementation, effectiveness, and vDOT impact persist fragmented and insufficiently systematized.
OBJECTIVE:
identify vDOT in PHC, assessing effectiveness, acceptability, equity, and catastrophic tuberculosis costs reduction.
METHODS:
Narrative review on BVS, MEDLINE and Pubmed databases using “tuberculosis”, “telemedicine” and “primary health care” descriptors. Articles published within the last five years, with complete texts online, about vDOT in tuberculosis care were included. Two reviewers independently screened titles and abstracts applied inclusion/exclusion criteria extracting data about outcome, acceptability and vDOT implementation in PHC. The methodological quality and evidence were assessed by GRADE approach, classifying the certainty of evidence as high, moderate, low or very low.
RESULTS:
vDOT is associated with high adhesion and treatment conclusion, low interruption of follow-up and increase of therapeutic conclusion, when compared to directly observed therapy, particularly benefiting socioeconomically vulnerable populations. vDOT presented high acceptability among patients and health professionals, improved access to health services, reduced costs, mitigated social and economic barriers and favoured continuous monitoring in PHC. vDOT, with close home and work monitoring, improves adherence, cure and reduces catastrophic costs, such as transportation, impoverishment, and multiple appointments.
CONCLUSIONS:
vDOT is a promissing estrategy for handeling tuberculosis in PHC, benefiting vulnerable populations. It allows centered care on the person and reduces visits to healthcare facilities, promoting equity and mitigating catastrophic costs, with moderate certainty evidence.
Tuberculosis remains world leader in mortality by infectious diseases, causing almost 1.3 million deaths annually. Socially marginalized populations are disproportionately affected, highlighting inequities in diagnosis and care. Recommended by World Health Organization, the directly observed video treatment (vDOT) is a digital health strategy focus on the person, that strengthens adherence, teleassistance access, and Primary Health Care (PHC) centrality in tuberculosis management. Evidences of implementation, effectiveness, and vDOT impact persist fragmented and insufficiently systematized.
OBJECTIVE:
identify vDOT in PHC, assessing effectiveness, acceptability, equity, and catastrophic tuberculosis costs reduction.
METHODS:
Narrative review on BVS, MEDLINE and Pubmed databases using “tuberculosis”, “telemedicine” and “primary health care” descriptors. Articles published within the last five years, with complete texts online, about vDOT in tuberculosis care were included. Two reviewers independently screened titles and abstracts applied inclusion/exclusion criteria extracting data about outcome, acceptability and vDOT implementation in PHC. The methodological quality and evidence were assessed by GRADE approach, classifying the certainty of evidence as high, moderate, low or very low.
RESULTS:
vDOT is associated with high adhesion and treatment conclusion, low interruption of follow-up and increase of therapeutic conclusion, when compared to directly observed therapy, particularly benefiting socioeconomically vulnerable populations. vDOT presented high acceptability among patients and health professionals, improved access to health services, reduced costs, mitigated social and economic barriers and favoured continuous monitoring in PHC. vDOT, with close home and work monitoring, improves adherence, cure and reduces catastrophic costs, such as transportation, impoverishment, and multiple appointments.
CONCLUSIONS:
vDOT is a promissing estrategy for handeling tuberculosis in PHC, benefiting vulnerable populations. It allows centered care on the person and reduces visits to healthcare facilities, promoting equity and mitigating catastrophic costs, with moderate certainty evidence.
| eISSN: | 2654-1459 |
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