{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:09:34Z","timestamp":1779127774551,"version":"3.51.4"},"reference-count":33,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2026,1,12]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>TB remains a major public health problem in Pakistan, a high-burden country with a high prevalence of multidrug-resistant TB (MDR-TB). Directly Observed Treatment (DOT) is widely used to improve treatment adherence; however, provincial-level evaluations remain limited, particularly in Sindh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To assess the effectiveness, outcomes, and challenges of DOT in Sindh Province over a 12-year period. A retrospective observational study was conducted including all patients enrolled in the National DOT Programme in Sindh from 2010 to 2022. Demographic, clinical, and treatment data were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Pulmonary MDR-TB was highly prevalent among individuals aged 16\u201335 years. Extensively drug-resistant TB (XDR-TB) accounted for 6.32% of cases and pan drug-resistant TB (PDR-TB) for 0.32%. Before enrolling into DOT, most patients (48.35%) had treatment outcomes that were not evaluated or had failed treatment (38.45%) in their previous non-DOT therapy. DOT achieved cure rates of 68% for long-term regimens and 75% for short-term regimens, with timely sputum conversion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>DOT was effective for managing MDR-TB; however, high MDR-TB prevalence, delayed diagnosis, treatment-related side effects, and patient loss to follow-up emphasise the need for strengthened early detection, adherence support, and monitoring strategies to improve treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/pha.25.0057","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:39:33Z","timestamp":1779125973000},"page":"75-80","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and challenges of DOT in multidrug-resistant TB: a 12-year retrospective study"],"prefix":"10.5588","volume":"16","author":[{"given":"S.","family":"Jabeen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Memon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Rashid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.N.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.M.","family":"Qadir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Akram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.W.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"2026051810392848000_16.2.75.1","doi-asserted-by":"crossref","unstructured":"Faisal S . 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