Patient Experiences of the Community Phase of the Directly Observed Treatment Short-Course for Tuberculosis in Malaita Province, Solomon Islands:

Tuberculosis (TB) is a major public health concern across the Pacific region.1 Solomon Islands, a Pacific Island country of approximately 600 000 people, records 350 to 400 cases of TB annually.1 The most populated province in Solomon Islands, Malaita (population 160 000), records 25% of all national TB cases.2 The TB cure rates of 64% nationally and 57% in Malaita2 are both well below the World Health Organization (WHO) target of >90%.3 Effective control of TB depends on 2 pillars: (1) early detection and (2) treatment completion. The Solomon Islands National TB Program adapted Directly Observed Treatment Short-course (DOTS) in 2003, based on the WHO-recommended STOP-TB strategy4 that includes both hospital (intensive) and subsequent community (continuation) phases. Throughout the community phase (4 to 6 months), patients ingest anti-TB drugs isoniazid and rifampicin while observed by a clinic nurse or responsible community person. DOTS has proven highly effective in many countries,5 but implementation of DOTS has faced numerous challenges across Pacific nations, including Solomon Islands. This study investigated the experiences of TB patients in the community phase in 2 TB hotspot areas in Malaita.