Directly Observed Therapy (DOT) is a widely recognized protocol for the treatment of tuberculosis, also recommended for certain other infectious diseases, aimed at preventing the emergence of drug-resistant strains. Initially developed in the early 1980s, drug-based tuberculosis treatment faced challenges due to inconsistent application, posing a global public health risk. The adoption of DOTS therapy in 1991 marked a significant milestone, with the World Health Organization collaborating with public health agencies to implement it.
Since its inception, tuberculosis treatment has evolved significantly, with the introduction of effective therapies like DOTS PLUS. Designed to be cost-effective, DOTS PLUS and TB drug treatments aim to extend benefits to a broader population. The success rate of a short course of DOT therapy is estimated to be around 80%.
Patients undergoing DOTS therapy receive close medication supervision, either by medical professionals or family members, ensuring the correct dosage and treatment progress. Residential clinic environments are often preferred for TB treatment to minimize the risk of negligence.
The successful implementation of DOTS encompasses five key elements:
- Political Commitment: Governments must demonstrate sustained financial dedication to support the availability of subsidized drugs for TB therapy, making it accessible to all. DOTS therapy is notably more affordable than alternative TB treatments.
- Individual Attention and Case Detection: Advanced laboratories, appropriate tools, skilled healthcare personnel, and bacteriology techniques are essential for effective case detection and management.
- Supervision: Supervision of treatment adherence should be conducted diligently to ensure patient compliance.
- Reliable Drug Supply System: A dependable drug supply system is crucial to prevent drug-resistant tuberculosis, necessitating consistent drug composition throughout the treatment course.
- Oversight System: Establishing an oversight system is vital for periodic evaluation of DOTS therapy outcomes and monitoring patient recovery.
By adhering to these elements, DOTS therapy can be successfully implemented, contributing to the effective management of tuberculosis and reducing the risk of drug resistance.