Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
DOTS & DOT
Outpatient department of Center for TB and Lung diseases of Riga East Clinical
hospital
Inga Lepse
DOTS – strategy for TB control
WHO recommends a Strategy
for TB control called DOTS
(Directly Observed Treatment, Short – course)
DOTS comprises 5 components
• Sustained political and financial commitment
• Diagnosis by quality ensured sputum – smear microscopy (passive case detection)
• Standardized short – course TB treatment given under direct and supportive observation
• Regular, uninterrupted, supply of anti-TB drugs
• Standardized recording and reporting
DOT
D-irectly
O-bserved
T-reatment
DOT • DOT by definition means watching patient
swallow each dose of anti-TB drugs
• Patients are supervised while medication is administered
• Implementation in Latvia – started in 1996
• It has been effective in controlling the spread of TB
TB Treatment • Long term
(6 – 9 months for susceptible TB;
18 – 24 months for MR TB);
• Drug combinations
• Under supervision
Why DOTS? • People can have problems taking medications
correctly
• Helps patient finish TB therapy as quickly as possible
• Helps prevent TB from spreading to others
• Decreases the risk of drug-resistance resulting from incomplete treatment
DOT includes
• Delivering the prescribed medication
• Checking for side effects
• Watching the patient swallow the medication
• Documenting the visit
• Answering questions
Tasks Involved in Delivering DOT
• Verify medication
• Check for side effects
• Watch patient take pills
• Document the visit
DOT providers
• Nurses
• Family doctors & nurses
• Trained healthcare workers
Excluding family members!
Clinic-based DOT
• TB hospital
• TB out patient department
• Family doctor
• General hospital
Field based DOT
• The patient's home
• The patient's workplace
• School, kindergarten
• Shelter
• Public park or other agreed-upon public location
• Restaurant
Advantages of DOT • It ensures that the patient completes an
adequate regimen
• It lets the health care worker monitor the patient regularly for side effects and response to therapy
• It helps the health care worker solve problems that might interrupt treatment
• By ensuring the patient takes every dose of medicine, it helps the patient become noninfectious sooner
Disadvantages of DOT
• Is time consuming
• Is labor intensive
• Can be insulting to some patients
• Can imply that the patient is incapable or irresponsible
• Can be perceived as demeaning or punitive