Directly observed treatment short course

DOTS treatment plan for pulmonary tuberculosis

1. Directly Observed treatment short course “DOTS” In Cases Of Tuberculosis

2. What is dots? Established by WHO in 1993 as a result of poor adherence to treatment plan by TB patients Involves direct observation by a health-care provider watching patient swallow their tablets, in a way that is sensitive & supportive to the patient’s needs. Is an important element in the internationally recommended policy package for TB control. It ensures that the patient takes: The right anti-TB drugs At the right doses And at the right intervals May be done in clinical setting or in the community.

3. (cont’d): Drugs should remain with the observer & should be given to the patient ONLY AT THE TIME OF INTAKE. It is required to ensure treatment adherence Helps to reinforce patient’s motivation to continue treatment. DOTS also ensure accountability of TB services & help prevent emergence of drug resistance. In general, family members of the patient SHOULD NOT serve as treatment observers. Successful candidates who may serve as treatment observers are: Healthcare providers Community member-also HIV/AIDS community care scheme workers Cured patients

4. Recommended For: Homeless people & drifters Alcohol & drug users Patients with serious mental illness Those with a history of non-compliance

5. What is involved? It basically consists of a combination chemotherapy: HRZE (H-isoniazid; R-rifampicin; Z-pyrazinamide; E-ethambutol) Regimens with daily, twice-weekly or thrice-weekly for 2-6 months have been devised. Hence, strategy leads to cure in about 95% of cases (roughly 85% of new cases!).

6. 5 components of DOTS: GOVERNMENT COMMITMENT(sustained political commitment). CASE DETECTION BY SPUTUM SMEAR MICROSCOPY. STANDARDIZED TREATMENT REGIMEN DRUG SUPPLY STANDARDIZED RECORDING & REPORTING SYSTEM That allows assessment of treatment results.

7. Additional: The DOTS program needs government support & funding to achieve a long-term TB control. The result of not instituting such a plan is obvious-increased numbers of cases of TB, MDR-TB & deaths.