This document reports on a study that assessed awareness of DOTS (Directly Observed Treatment, Short-course) among medical practitioners in Mysore, India. The study found that overall awareness and usage of DOTS was low, particularly among doctors who graduated before DOTS was included in the curriculum and those practicing in the private sector. However, doctors working in government sectors felt DOTS was more effective than other treatment methods. The study concludes there is a need for improved communication between tuberculosis programs and doctors, and suggestions are made to enhance DOTS education and engagement of private medical practitioners.

1. Mysore Medical College & Research Institute, Mysore, Karnataka *Safdarjung Hospital, New Delhi Is Awareness of DOTS among Medical Practitioners in Mysore a Worry? Mudassir Azeez Khan , Sonal Agarwal, Vinayaknagaraja, Ganraj Bhat, Ghazal Dutta, Ashwini B. R., Abhinit Kumar *

2. BACKGROUND RNTCP introduced in 1993 March 2006 – 100% DOTS Coverage by RNTCP DOTS – Major Public Health Breakthrough

3. OBJECTIVES 1. To study the extent of awareness of DOTS. 2. To compare DOTS awareness and usage among doctors based on criteria like: Their graduation before or after the inclusion of DOTS in curriculum The type of health centre they work in Their field of specialty 3. Impact of DOTS related myths and misconceptions among doctors.

4. METHODOLOGY A cross-sectional comparative study Subjects – 311/401 Registered Medical Practitioners in Mysore District who come across TB patients Scope based Questionnaire preparation & Data Gathering Statistical analysis using chi square test

5. THE BREAK-UP

6. WORK SET-UP

7. FIELD OF SPECIALTY

8. THE PRE- & POST- RNTCP ERA

9. BASIC INFORMATION ABOUT DOTS

10. THOSE WHO DO PRACTICE DOTS

11. WHY NOT DOTS FOR ALL?

12. THOSE WHO DO NOT PRACTICE DOTS

13. COST ESTIMATION

14. ADOPTING DOTS & MISCONCEPTIONS

15. RESULTS Overall Usage/Awareness of DOTS – LOW Considerably low (p< 0.001) among doctors Graduating before inclusion of DOTS into curriculum Practicing in the Private Sector Orthopedic Surgeons, Gynecologists, Pediatricians

16. SITUATION NOT SO DULL… 100% of the doctors working in Government sector felt that DOTS was better than NTCP. Most of the doctors who practiced DOTS felt that it was highly effective in treating TB.

17. CONCLUSIONS Communication gap between RNTCP & its implementers (doctors) Need for a parallel social network to help doctors implement DOTS Need for proactive involvement of medical practitioners

18. SUGGESTIONS Workshops & CMEs More emphasis about DOTS in Medical Curriculum Expand the scope of RNTCP to engage more doctors Authorize some private hospitals & nursing homes as Microscopy Centers

19. SUGGESTIONS contd... Develop supply chain to ensure DOTS availability Directory of all Medical Practitioners and a nationwide toll-free helpline Education and direct involvement of nurses, health workers and pharmacists Adherence to counseling of the patients DOTS - Fact sheet & CD for doctors

20. THANK YOU RNTCP