Video observed treatment for TB patients. Belarus experience

<b>Background:</b> Recommended by WHO people-centered integrated care and the use of e-health approach are important components of proper management of TB patients. Video observed treatment (VOT) is in line with both components. With the Global Fund’s support a pilot VOT project was expanded across the country in Belarus as of October 2016. <b>Methods:</b> Patients were provided with smartphones and internet access, and briefed on how to record and transmit video files to trained clinic staff. Measures to monitor outcomes of VOT treatment prospectively in the countrywide cohort were developed. <b>Results:</b> By February 1, 2020, 1111 drug susceptible and drug resistant TB patients across the country were recruited: median age 36 years; 64% male; 54% employed, 4% students, 38% unemployed, 4% on maternity leave; 41% with DS-TB, 59% with RR/MDR-TB, including 14% with XDR-TB. Final treatment outcomes were recorded in 816: DS-TB (n=656) treatment success - 97%; RR/MDR-TB (n=160) treatment success - 87%. In both cohorts lost to follow up (LTFU) was 2% only (LTFU was 12% - in countrywide RR/MDR-TB cohort). <b>Conclusions:</b> In addition to high levels of patient acceptability and treatment adherence our data demonstrate excellent treatment outcomes using VOT in DS-TB and RR/MDR-TB patients.