Feasibility of home-based and health centre-based DOT: perspectives of TB care providers and clients in an HIV-endemic area of Thailand

Focus groups were conducted in a high human immunodeficiency virus (HIV) pr evalence area of Thailand to elicit perspectives of health staff and client s regarding the feasibility of directly observed therapy (DOT) for tubercul osis. Most participants perceived health centre-based DOT to be impractical for clients due to severe illness, travel inconvenience, and interference with employment. Most providers perceived home-based DOT to be difficult be cause of the inconvenience of travel, staff shortages and the high tubercul osis caseload. Most clients except HIV-negative tuberculous females conside red home visits to be undesirable due to stigma. The preparedness of provid ers for home-based DOT might be improved through awareness building among s taff about multidrug-resistant tuberculosis.