What is DOTS?

DOTS is an internationally recommended strategy for controlling TB. It stands for Direct Observed Treatment, Short- course, and combines five elements -- political commitment, microscopy services, drug supplies, surveillance and monitoring systems, and the use of highly efficacious regimes with direct observation of treatment.

Once patients with infectious TB (bacilli visible in a sputum smear) have been identified using microscopy services, health and community workers and trained volunteers observe and record patients taking their daily treatment, over the full course of anti-TB medicines advised (treatment lasts between six and eight months). The most common anti-TB drugs are isoniazid, rifampicin, pyrazinamide, streptomycin and ethambutol.

Sputum smear testing is repeated after two months, to check progress, and again at the end of treatment. A recording and reporting system documents patients' progress throughout, and the final outcome of treatment.

* DOTS is THE MOST EFFECTIVE STRATEGY available for controlling the TB epidemic today

* DOTS produces cure rates of up to 95 percent, even in the poorest countries.

* DOTS prevents new infections by curing infectious patients.

* DOTS prevents the development of multidrug-resistant tuberculosis (MDR-TB) by ensuring the full course of treatment is followed.

A six-month supply of drugs for DOTS costs US$11 per patient in some parts of the world. The World Bank has ranked the DOTS strategy as one of the "most cost-effective of all health interventions".

Since DOTS was introduced on a global scale in 1995, over 10 million infectious patients have been successfully treated under DOTS programs. In half of China, the cure rate among new cases is 96 percent. In Peru, widespread use of DOTS for more than ten years has led to the successful treatment of 91 percent of cases, and a reduction in the incidence of new cases.

-- Source: www.who.int/gtb/dots/