Table 1.

Key components of the ETA programme and of DOT

DOT	ETA
Training: Standard nurse training for nurses; 5 day training for lay DOT supporters	Training: Additional 1 day induction to the ETA for nurses; additional 3 day induction to the programme for DOT supporters (now called treatment supporters); adherence counsellor training for ex-DOT supporters, including five days of programme training and five days of counselling training
Patient is initiated onto directly observed therapy in the clinic (takes treatment once a day under supervision of the TB nurse)	Before initiating self-administered treatment, the patient is placed on directly observed therapy in the clinic for a short period (takes treatment once a day under the supervision of the TB nurse for approximately 2 weeks) to identify problems that might preclude self administration of treatment
Mode of treatment delivery: directly observed therapy	Mode of treatment delivery: self administration at home with pill counts by treatment supporter
Short information session about TB, and its treatment, given by the TB nurse	Trained lay adherence counsellor gives TB information to the participant in 3-4 counselling sessions, of half an hour each, focusing on treatment education, side effects, healthy living and adherence planning and TB and HIV
No visits are made routinely to patients' homes	A treatment supporter conducts a home visit to document the patient's home circumstances and verify their address. TB contacts, immunocompromised persons and children under 5 years in the household are also referred to the clinic for testing and vaccinations
No meeting of different role-players to discuss treatment support	Nurse, adherence counsellor and treatment supporter meet to discuss each patient's eligibility for self administration
Patient can receive DOT in the workplace, or by visiting a DOT supporter in the community	Patient can take treatment in the workplace, or at a clinic, but can also obtain a one month supply of tablets from the clinic and self-supervise their treatment
Nurse sees patient at diagnosis, for DOT, for 2/3 month sputum and at the end of treatment	Nurse sees patient at diagnosis, DOT for two weeks and, if the patient is eligible for self-administration, once per month until the end of treatment and for 2/3 month sputum and end of treatment sputum
If the patient is placed on community based DOT, s/he visits a treatment supporter once a day to receive treatment. Maximum DOT supporter caseload is 30 patients per month.	If the patient is placed on the ETA model, a treatment supporter visits the patient three times in the first week and once a week thereafter to monitor treatment taking. Maximum treatment supporter caseload is 60 patients per month.
No formal integration of family or friends into the treatment plan	Treatment "buddy" has an important role - s/he attends counselling and acts as a support and reminder to the patient. The buddy can be a friend, family member or neighbour of the patient