7/17/2019 Dots

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DOTS (directly observed treatment, short-course), is the name given to the World Health

Organization-recommended tuberculosis control strategy that combines five components:

• Government commitment (including both political ill at all levels, and establishing a

centralized and prioritized system of !" monitoring, recording and training)

• #ase detection by sputum smear  microscopy

• $tandardized treatment regimen directly observed by a healthcare or%er or community

health or%er for at least the first to months

• & regular drug supply

• & standardized recording and reporting system that allos assessment of treatment results

!he technical strategy for 'O!$ as developed by 'r arel $tyblo in the *+s, primarily in

!anzania .n *++, the World Health Organization and the World "an%  began investigating the

 potential e/pansion of this strategy .n 0uly *++, the World "an%, under 1ichard "umgarner 2sdirection, invited 'r $tyblo and WHO to design a !" control pro3ect for #hina "y the end of

*++*, this pilot pro3ect as achieving phenomenal results, more than doubling cure rates among

!" patients #hina soon e/tended this pro3ect to cover half the country

'uring the early *++s, WHO determined that of the nearly 4 different tas%s involved in 'r$tyblo2s system, only * of them ere essential to run an effective !" control program 5rom

this, WHO2s relatively small !" 6nit at that time, under 'r &rata ochi2s leadership, developed

an even more concise 75rameor% for !" #ontrol7 focusing on five elements and nine %eyoperations !he emphasis as on 7'O!, or directly observed therapy, using a specific

combination of !" medicines %non as short-course chemotherapy as one of the five essential

elements for controlling !"

.n *++8, WHO developed a promotion strategy to brand this comple/ public health intervention"y mar%eting 7'O!$7 to global public health decision ma%ers, turning the ord 7dots7 upside

don to spell 7stop,7 proved an effective shorthand toard promoting 7$top !" 6se 'ots97 for

health policy messages*;

!his contributed to a steady global upta%e of 'O!$ !" control services over the subse<uentdecade Whereas less than => of infectious !" patients ere being detected and cured from !"

ith 'O!$ treatment services in *++, appro/imately ?> are no benefiting from this care$ince *++8, @* million people have been successfully treated and up to ? million lives savedthrough 'O!$ and the $top !" $trategy 8 million !" cases ere notified through 'O!$

 programmes in =+=;

'O!$-Alus is for multi-drug-resistant tuberculosis (B'1-!")