What is the DOTS strategy?

‘DOTS’ stands for Directly Observed Treatment – Short course. With the DOTS strategy the patient is given the anti-TB drugs by some responsible person in the community who observes the patient swallowing every dose of the medication. The treatment supporter does not have to be a health professional. With adults, it is best if the treatment supporter is not a family member. This ensures good compliance without the patient having to go to the clinic for every dose. If DOTS is correctly used, the failure rate of treatment is greatly reduced and over 85% of patients should be cured. The general public can play an important role in the control of TB by supporting DOTS (i.e. DOTS supporters). The cure rate for TB without DOTS in poor countries may be as low as 40%.

The DOTS strategy consists of 5 main points: Government commitment to sustained TB control activities; case detection by sputum smear microscopy among symptomatic patients; self-reporting to health services; standardized treatment regimens of 6 to 8 months for at least all confirmed sputum smear positive cases, with directly observed treatment (DOT) for at least the initial 2 months; a regular, uninterrupted supply of all essential anti-TB drugs; and a standardized recording and reporting system that allows assessment of treatment results for each patient and of the TB control programme overall. DOTS was introduced to South Africa in 1996.

With DOTS a responsible person must see the patient take the tablets.

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