Directly Observed Therapy – Short Course

Directly Observed Therapy – Short Course (DOTS) is a tuberculosis (TB) control strategy recommended by the World Health Organization (WHO). It has been recognized as a highly efficient and cost-effective strategy.

Overview

DOTS was developed in the 1990s in an effort to combat the growing epidemic of TB. The strategy involves observing patients as they take their TB medication to ensure adherence to the treatment regimen. This is done to prevent the development of drug-resistant tuberculosis, which can occur when patients do not complete their full course of medication.

Components

The DOTS strategy consists of five main components:

1. Political commitment with increased and sustained financing
2. Case detection through quality-assured bacteriology
3. Standardized treatment with supervision and patient support
4. An effective drug supply and management system
5. Monitoring and evaluation system, and impact measurement

Implementation

Implementation of DOTS involves the collaboration of healthcare providers, non-governmental organizations (NGOs), and community health workers. Patients are required to visit a health facility or meet with a health worker daily or several times a week to take their medication. This direct observation ensures that patients complete their treatment and do not develop drug-resistant TB.

Effectiveness

Studies have shown that DOTS is an effective strategy for controlling TB. It has been found to increase treatment completion rates and decrease rates of drug-resistant TB. However, the success of DOTS is dependent on the strength of the healthcare system and the level of resources available.

Challenges

Despite its effectiveness, DOTS faces several challenges. These include the need for significant resources and infrastructure, the difficulty of reaching remote or marginalized populations, and the stigma associated with TB.

See also

• Tuberculosis management
• Tuberculosis treatment
• Public health