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Strategy
DOTS is a systematic strategy which has five components
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Political and administrative commitment. TB is
the leading infectious cause of death among adults. It kills
more women than all causes associated with childbirth combined
and leaves more orphans than any other infectious disease. And,
since TB can be cured and the epidemic reversed, it warrants
the topmost priority, which it has been accorded by the Government
of India. This priority must be continued and expanded at the
state, district and local levels. |
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Good quality diagnosis. Top quality microscopy
allows health workers to see the tubercle bacilli and is essential
to identify the patients who need treatment the most. |
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Good quality drugs. An uninterrupted supply of
good quality anti-TB drugs must be available. In the RNTCP,
a box of medications for the entire treatment is earmarked for
every patient registered, ensuring the availability of the full
course of treatment to the patient the moment he is registered
for treatment. Hence in DOTS, the treatment will never fail
for lack of medicine. |
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The right treatment, given in the right way. The
RNTCP uses the best anti-TB medications available. But unless
treatment is made convenient for patients, it will fail. This
is why the heart of the DOTS programme is "directly observed
treatment" in which a health worker, or another trained person
who is not a family member, watches as the patient swallows
the anti-TB medicines in their presence. |
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Systematic monitoring and accountability. The
programme is accountable for the outcome of every patient treated.
The cure rate and other key indicators are monitored at every
level of the health system, and if any area is not meeting expectations,supervision
is intensified.The RNTCP shifts the responsibility for cure
from the patient to the health system. |
It is realized in the past decade that Tuberculosis control demands a comprehensive and sustained response, complementing measures to address the social and environmental factors that increase the risk of developing TB. Hence a comprehensive strategy is formulated by the WHA called “Stop TB Strategy”. The Stop TB Strategy both builds on the existing DOTS strategy and expands its scope to address remaining constraints and challenges to TB control This is critical for achievement of the Millenium Development Goals and related Stop TB Partnership targets for TB control. The Stop TB Strategy has following objectives and components
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