DOTS treatment plan for pulmonary tuberculosis

1. DIRECTLY OBSERVED
TREATMENT SHORT COURSE
“DOTS” In Cases OfTuberculosis

2. WHAT IS DOTS?
 Established byWHO in 1993 as a result of poor adherence to treatment plan byTB
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 forTB
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
THETIME OF INTAKE.
 It is required to ensure treatment adherence
 Helps to reinforce patient’s motivation to continue treatment.
 DOTS also ensure accountability ofTB 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:
1) GOVERNMENT COMMITMENT(sustained political commitment).
2) CASE DETECTION BY SPUTUM SMEAR MICROSCOPY.
3) STANDARDIZEDTREATMENT REGIMEN
4) DRUG SUPPLY
5) 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.