DOTS strategy for control of tuberculosis epidemic.

ABSTRACT

The article reviews the elements of the DOTS strategy to control the tuberculosis epidemic WHO declared TB" a global emergency" in 1993, the impact of which is worsened by the emergence of multi drug-resistant TB (MDR-TB) and the spread of HIV/AIDS. DOTS (directly-observed treatment, short-course) is an intermittent, supervised system of drug-intake by patient, which eliminates drug-default. It has been described by WHO as "the most important public health breakthrough of the decade in terms of lives saved" The 5 major components of DOTS are i) Political will, ii) High-quality microscopy, iii) Uninterrupted supply of short-course chemotherapy drugs, iv) Directly--observed chemotherapy regimen use, v) Systemic monitoring using the TB cure rate. Standardized, intermittent DOTS regimens are classified using three categories of disease. The main advantages of DOTS are (i) Cure rates of upto 95%, (ii) Prevention of MDR--TB emergence, (III) Improvement of longevity of AIDS patients by TB control, (iv) It is "one of the most cost-effective of all health interventions", according to World Bank.