Tuberculosis (TB) is an infectious disease of the lungs that needs long-term medication to cure. Antibiotic resistance can develop in patients who do not follow an effective treatment regimen. Direct Observation Therapy — Short Course (DOTS) — is a globally recognized method of ensuring TB patients take all the necessary medication. The therapy can cure a large proportion of TB patients, lower disease transmission rates, and reduce the development of drug resistance.
DOTS protocol lays out several conditions for governments, healthcare workers, and patients to follow. Firstly, a government has to provide the logistical framework necessary. A laboratory must identify the presence of TB in a sputum sample, which confirms the person has active disease.
Each patient must have access to suitable medication for the duration of treatment. The healthcare system also must monitor the efficacy of each treatment. Central to DOTS therapy is that a healthcare worker observes each dose of medication to ensure the patient is following the antibiotic treatment regimen adequately.
The major issue historically with tuberculosis treatment is that the disease takes so long to cure. In the past, some patients grew bored of taking medicine regularly for months or years, and the tuberculosis bacteria adapted to the insufficient medicine. TB changed from a disease that was easily treatable with antibiotics to one that resisted a range of treatments. Today, DOTS therapy ensures that the patient gets into a proper routine and doesn't skip any medication.
DOTS therapy therefore increases the percentage of people who are cured of the disease. For example, according to the World Health Organization (WHO), countries such as Bangladesh, Nepal, and China achieve cure rates of over 80 percent. People who have HIV can also be susceptible to tuberculosis, and the protocol is effective in reducing mortality rates in affected individuals.
Another benefit of DOTS therapy is that a patient undergoing the therapy has a reduced risk of infecting other people as the TB is controlled. If a person who self-administers the medication fails to follow a proper regimen, he or she can become actively infectious again. The therapy therefore protects the general population from infection and reduces the transmission rate.
The DOTS system can also be cost-effective, especially in countries that suffer from a high burden of disease. The care and treatment of tuberculosis patients costs money. Infected people can also be unable to work or go to school and so contribute little to the economy. DOTS therapy can benefit the country in the long term by reducing the prevalence of the illness, which lowers the cost burden on healthcare facilities and allows more citizens to be economically productive.
