Abstract: ObjectiveTo investigate the status of DOT management in poor and remote area, and to identify the existing problems and the influencial factors of it. MethodsTwo counties with the population at 400000 or above were randomly selected in the remote and poverty counties in Gansu province. The quarterly and annual data in 2005 and 2006 were collected and analyzed. Twelve townships whose distance to county center was more than l0 km were selected to conduct questionnaire interview and follow-up survey among the smear positive PTB cases that have completed the treatment before 2005, which was designed to understand the DOTS management status and its influencial factors and to evalaute the quality of DOTS in poor and remote area. ResultsThe DOTS coverage of the 109 smear positive cases was 19.3%, and 75.2% patients was not covered by DOTS and took drugs by themselves; the cure rate was 41.3% and the completion rate was 38.5%, 18.4% of the total cases did not regularly take medicine. The low coverage of DOTS was mainly due to the insufficiency in human resource, time and financial support at county, township and village levels. The factors related with the drug intake and frequency of sputum examiniation included age, TB awareness, quality and frequency of DOTS, and side-effect. ConclusionsThe quality of DOTS management in poor and remote area is low. It is urgent to develop DOTS management Methods adaptable to the local situation in poor and remote area and to improve the TB awareness among various group in the poor and remote area.

Key words: pulmonary tuberculosis/prevention and control, poverty areas, Gansu province