Adherence of Physicians to the National Tuberculosis Control Program (DOTS Strategy) and associated factors in Birjand City

Bostani, MORTEZA; Dehghani, Mohsen; Taghipour, Ali; Raufi, Farah; Bostani, Benyamin

doi:10.66224/jhrd.4.2.94

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Volume 4, Issue 2 (Summer 2026)

Iran J Health Res Dev 2026, 4(2): 94-106

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Adherence of Physicians to the National Tuberculosis Control Program (DOTS Strategy) and associated factors in Birjand City

MORTEZA Bostani¹

, Mohsen Dehghani¹

, Ali Taghipour ^*²

, Farah Raufi³

, Benyamin Bostani

1- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. , taghipoura@mums.ac.ir
3- Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract: (470 Views)

Background: Poor Physician Adherence to DOTS strategy is one of the reasons for the failure of tuberculosis control. The aim of this study was to evaluate the level of adherence of physicians in Birjand to DOTS and determine the related factors.

Methods: This research was an analytical cross-sectional study. The study population consisted all general physicians, internal physicians, pediatrics and infection disease specialists who were active in Birjand in 2024. A valid and reliable questionnaire, including demographic and 20 scenario-based multiple-choice questions based on the DOTS strategy was used to collect data. Differences in compliance among groups were assessed using T-test and ANOVA, and factors associated with compliance were determined using multiple linear regression analysis with SPSS version 26.

Results: All eligible physicians in study were 121 in which 109 individuals responded to the questionnaire (response rate: 91%). The mean age was 37.28 ± 7.5 years, 56% of them were male and 75.2% (82 persons) were general practitioners. Approximately 15% of physicians had no familiarity with DOTS. The mean adherence score to DOTS was 10.51 ± 4.5 out of 20 which rated as inappropriate. The adherence scores in diagnosis, follow-up, and follow-up of the contacts were 2.42 ± 1.07, 1.99 ± 1.22, and 2.61 ± 1.06 out of 4, while for treatment was 3.49 (± 1.76) out of 8. Multiple linear regression analysis indicated a significantly higher adherence score among female compared to male physicians (β = 1.65, p = 0.02). Prior good familiarity (β = 5.4, p < 0.001) and brief familiarity with DOTS (β = 2.47, p = 0.019) were significantly associated with a higher adherence score compared to no familiarity.

Conclusion: The adherence of Birjand physicians to the DOTS was inappropriate. Females and physicians with Prior good and brief familiarity with DOTS had a higher compliance rate.

Keywords: Adherence, DOTS Strategy, Tuberculosis, Physicians

Acknowledgments: The authors would like to express their sincere gratitude to all faculty members and colleagues who provided guidance and support throughout the research process. We also sincerely appreciate the valuable cooperation and assistance of the respected staff members of the Birjand Medical Council, as well as the colleagues at the Deputy of Health and Deputy of Treatment of Birjand University of Medical Sciences, who contributed to the successful completion of this study.

Conflict of Interest: The authors declare that there is no conflict of interest in relation to this study.

Availability of Data and Materials: The data and materials related to this study are available from the corresponding author upon reasonable request.

Consent for Publication: Not applicable.

Ethics Approval and Consent to Participate: This study was registered and approved by the Ethics Committee of Mashhad University of Medical Sciences (Ethics Code: IR.MUMS.FHMPM.REC.1403.114). The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Prior to participation, the objectives and procedures of the study were fully explained to all participants, and written informed consent was obtained from each participant. The confidentiality of participants' information and the protection of their privacy were maintained throughout all stages of the research.

Funding: This study was extracted from a master's thesis and was financially supported by the Research and Technology Vice-Chancellorship of Mashhad University of Medical Sciences (Project Code: 4030365).

Authors' Contributions: All authors made substantial contributions to the study design, data collection, analysis, interpretation of results, drafting of the manuscript, and critical revision of the final version.Taghipour contributed to project management, scientific supervision, and final manuscript editing. Morteza Bastani and Dehghani contributed to the study concept, methodology, data analysis, initial manuscript drafting, and final revision.Benjamin Bastani and Raoofi contributed to data collection, interpretation of findings, and revision of the initial draft.All authors reviewed and approved the final version of the manuscript and accept responsibility for the accuracy, integrity, and overall content of the work.

Full-Text [PDF 888 kb] (48 Downloads)

Type of Study: Original | Subject: General

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‎ 10.66224/jhrd.4.2.94

Ethics code: IR.MUMS.FHMPM.REC.1403.114

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Bostani M, Dehghani M, Taghipour A, Raufi F, Bostani B. Adherence of Physicians to the National Tuberculosis Control Program (DOTS Strategy) and associated factors in Birjand City. Iran J Health Res Dev 2026; 4 (2) :94-106
URL: http://jhrd.trjums.ac.ir/article-1-166-en.html

Open Access Statement: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium or format, provided that the original work is properly cited.

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