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Enhancing DOTS Strategy for TB Control

Pursue high-quality DOTS expansion and enhancement The document discusses strengthening the five core components of DOTS (Directly Observed Treatment, Short-course), which remains central to the Stop TB Strategy. The five components are: political commitment and sustained financing; case detection through quality-assured bacteriology; standardized treatment with supervision and patient support; an effective drug supply and management system; and monitoring and evaluation. Expanding and enhancing these five DOTS components through addressing known constraints and new challenges is needed to further progress in tuberculosis control and treatment.

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Kityn Evangelista
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24 views2 pages

Enhancing DOTS Strategy for TB Control

Pursue high-quality DOTS expansion and enhancement The document discusses strengthening the five core components of DOTS (Directly Observed Treatment, Short-course), which remains central to the Stop TB Strategy. The five components are: political commitment and sustained financing; case detection through quality-assured bacteriology; standardized treatment with supervision and patient support; an effective drug supply and management system; and monitoring and evaluation. Expanding and enhancing these five DOTS components through addressing known constraints and new challenges is needed to further progress in tuberculosis control and treatment.

Uploaded by

Kityn Evangelista
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd

Pursue high-quality DOTS expansion and

enhancement

LHIL/JP Zellweger

DOTS remains at the heart of the Stop TB Strategy. To enable known constraints to be addressed
and new challenges met, further strengthening of the basic five components of the DOTS
approach is required.

Five components of DOTS:

• 1. Political commitment with increased and sustained financing


Legislation, planning, human resources, management, training
• 2. Case detection through quality-assured bacteriology
Strengthening TB laboratories, drug resistance surveillance
• 3. Standardized treatment with supervision and patient support
TB treatment and programme management guidelines, International Standards of TB
Care (ISTC), PPM, Practical Approach to Lung Health (PAL), community-patient
involvement

• 4. An effective drug supply and management system


Availability of TB drugs, TB drug management, Global Drug Facility (GDF), Green
Light Committee (GLC)
• 5. Monitoring and evaluation system and impact measurement
TB recording and reporting systems, Global TB Control Report, data and country
profiles, TB planning and budgeting tool, WHO epidemiology and surveillance online
training

What is DOTS?

Tuberculosis is curable and DOTS (directly observed treatment, short-course) is proven to be the most
successful and cost-effective treatment strategy. The objectives of the DOTS strategy are to decrease the
risk of infection, reduce morbidity and the transmission of infection, and prevent TB deaths. Achieving these
objectives through the DOTS strategy is simple:

• Identify TB cases in communities around the world, particularly those in developing countries.

• Treat TB cases by directly observing their medication intake for six to eight months. This is to
ensure that medication is taken in the right combination and appropriate dosage in an effort to prevent
the development of multidrug resistant TB.
The DOTS strategy focuses on the following operational targets: detect at least 70% of the new smear-
positive TB cases and cure at least 85% of these cases. With direct observation of treatment, it is
anticipated that 80% of deaths attributed to TB worldwide will be prevented.

Five key elements are essential for the DOTS strategy to be successful:

• Sustained political commitment to increase human and financial resources and make TB control a
nationwide activity as part of a national health system.

• Access to quality-assured TB sputum microscopy for case detection among people with, or found
through screening to have, symptoms of TB (most importantly prolonged cough). Special attention is
necessary for case detection among HIV-infected people and other high-risk groups, e.g. people in
institutions.

• Standardized short-course chemotherapy to all cases of TB under proper case-management


conditions, including the direct observation of treatment. Proper case-management conditions imply
technically sound and socially supportive treatment services.

• Uninterrupted supply of high quality drugs with reliable drug procurement and distribution
systems.

• Recording and reporting system enabling outcome assessment of each and every patient and
assessment of the overall programme performance.

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