Notes from the Field: Use of Asynchronous Video Directly Observed Therapy for Treatment of Tuberculosis and Latent Tuberculosis Infection in a Long-Term–Care Facility ― Puerto Rico, 2016–2017

Post Date: 
Morbidity and Mortality Weekly Report

emocha's video Directly Observed Therapy is highlighted in this report.

. . . As of July 12, 2017, all 11 patients with active TB disease and all six with LTBI had completed treatment with recommended ≥80% compliance (percentage of scheduled doses actually taken) (Table) (6). Active TB disease treatment rates were higher than those for LTBI because protocols exist for treating 5 days per week; LTBI treatment, however, is normally 7 days per week and, in this case, was extended by 1 month to achieve ≥80% compliance. All patients with active TB disease have shown clinical signs of improvement. In addition to using daily symptom queries attached to the videos and telephonic communication as needed, the medical director used asynchronous VDOT to observe directly any complex patients on multiple hepatotoxic drugs for side effects that could interfere with treatment compliance and to verify a daily measurement of treatment completion. VDOT has been demonstrated to be cost-effective in multiple settings (5). CDC has developed an eDOT toolkit ( to facilitate adoption of these practices.