The Directly Observed Treatment Strategy

In order to be cured, a tuberculosis patient has to take 2-3 drugs a day for 6-9 months. This is not easy. Many patients feel like ending their treatment no sooner they feel better, after a few months that is. However, breaking off treatment half-way is the worst thing one can do because the disease will very likely recur. Some patients develop drug resistance as a result.

Find out more about drug resistance.

The WHO recommends the Directly Observed Treatment Strategy

In order to guarantee complete and adequate treatment, the WHO recommends DOTS. According to recent figures, 77% of tuberculosis patients currently live in areas where DOTS is applied. The Damien Foundation helps 16 countries to apply the strategy.

The basic Directly Observed Treatment Strategy involves five factors :

1. The local authorities' political commitment towards tuberculosis control.
2. Confirming diagnosis by detecting the Koch bacillus contained in sputum.
3. Full standard treatment with directly supervised drug intake for at least the infectious cases.
4. A constant supply of high quality drugs.
5. Standard recording and reporting.

1. Local authorities' political commitment towards tuberculosis control

Without the local authorities' cooperation, we cannot combat tuberculosis effectively.

2. A diagnosis based on examining sputum

Clinical symptoms and X-rays are insufficient evidence to prove the presence of tuberculosis. Only the presence of the Koch bacillus in sputum proves that tuberculosis is the cause of signs and symptoms that were observed. Any diagnosis based only on X-rays bears the risk of "over-diagnosing" and treating individuals who are not affected by tuberculosis.

3. A complete treatment

All cases of tuberculosis require full treatment. However, direct observation of drug intake is more important in infectious cases. These patients run a greater risk of dying than of developing drug resistance if they do not take the full course of treatment or if they break off their treatment prematurely.

4. Available drugs

There are very efficient anti-tuberculosis drugs. However, in order to be efficient, all drugs have to be available for all patients undergoing treatment, unfailingly and without delay.

5. Standardised recording and retrieval

All patients have to be recorded. Treatment results must also be set on record each time and reported in standardised way. This will enable us to monitor a programme, detect problem areas and, if necessary, modify our support.