DOTS &DOTS PLUS
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DOTS &DOTS PLUS. VIPIN CHANDRAN.C. DOTS. A community based TB Rx and care strategy which combines the benefits of Supervised Rx Community based care and support. DOTS IN INDIA. Launched in march 1997 Covered by march 2006
DOTS &DOTS PLUS
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DOTS &DOTS PLUS VIPIN CHANDRAN.C
DOTS • A community based TB Rx and care strategy which combines the benefits of • Supervised Rx • Community based care and support
DOTS IN INDIA • Launched in march 1997 • Covered by march 2006 • INDIA, the second largest country in the world in terms of population coverage under DOTS • 72% case detection by 2004 • 85% cure rate consistently
DOTS – HOW DOES IT WORK??? • Intensive phase • Continuation phase • PATIENTWISE BOXES • MULTI-BLISTER COMBI PACK x 1 WEEK
INH - 600mg Rifampicin - 450mg Pyrazinamide 1500mg Ethambutol -1200mg Streptomycin -750mg Dosage of drugs
Who can be a DOTS provider ? • Family member ..? NO • Peripheral health staff , voluntary health workers, teachers, ex-patients…
DOTS - ADVANTAGES More accurate diagnosis of TB Prevents spread of infection thus reducing incidence and prevalence Prevents Rx failure & emergence of MDR TB Alleviate poverty Lends credibility to TB control efforts Removes stigma associated with TB
MDR TB INH & RIFAMPICN XDR TB Why drug resistance ???...
DOTS PLUS • GOAL Prevent further dvpt of MDR • Principle Prevention of MDR by FULL implementation of DOTS
WHO 7-POINT PLAN OF ACTION • Develop national emergency response for MDR & XDR, and ensure TB control programmes meet global standards • Conduct rapid surveys to asses geographical &temporal distribution • Strengthen & expand national TB labs. • Implement infection control precautions with special emphasis on high risk groups.
Establish capacity for clinical & public health managers to respond effectively to MDR & XDR TB • Promote universal acess to ART for all TB patients. • Increase funding & support for dvpt of new drugs & diagnostic methods.