Directly observed treatment short-course (DOTS).

Directly observed treatment short-course (DOTS) is recommended by the World Health Organisation (WHO) globally for control of tuberculosis (TB). DOTS strategy which aims at detecting at least 70% of the existing cases of sputum smear-positive cases and curing at least 85% of these newly detected cases has been observed not only to ensure cure but also reduce the number of deaths due to TB. DOTS also results in the reduction of the prevalence of TB by reducing the pool of infectious cases and curtailing the disease transmission. The short-course anti-tuberculosis treatment regimens employed in the DOTS strategy are effective and the supply of drugs is uninterrupted. As regular drug intake is ensured with DOTS strategy by direct observation drug resistance and relapses develop less frequently. The revised national tuberculosis control programme (RNTCP) of India has adopted the DOTS strategy for the control of TB and has expanded rapidly during the last five years. From a coverage of 18 million in mid-1998 as of June 30 2003 DOTS coverage has expanded to 712 million of India’s population. India’s DOTS programme is the second largest in the world. The current expansion is rapidly progressing and the entire country is expected to be covered by 2005. The initial experience with DOTS suggests that in areas of the world where the prevalence of drug-resistant TB is high modifications such as “DOTS-Plus” strategy may be required to achieve the desired results. From a public health point of view the DOTS strategy is indeed one of the most cost-effective health interventions ever conceived. (authors)