1. DOTS &DOTS PLUS VIPIN CHANDRAN.C

2. DOTS • A community based TB Rx and care strategy which combines the benefits of • Supervised Rx • Community based care and support

3. 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

4. CATEGORISATION

5. DOTS – HOW DOES IT WORK??? • Intensive phase • Continuation phase • PATIENTWISE BOXES • MULTI-BLISTER COMBI PACK x 1 WEEK

6. DOTS

7. INH - 600mg Rifampicin - 450mg Pyrazinamide 1500mg Ethambutol -1200mg Streptomycin -750mg Dosage of drugs

8. Who can be a DOTS provider ? • Family member ..? NO • Peripheral health staff , voluntary health workers, teachers, ex-patients…

9. 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

10. MDR TB INH & RIFAMPICN XDR TB Why drug resistance ???...

11. DOTS PLUS • GOAL Prevent further dvpt of MDR • Principle Prevention of MDR by FULL implementation of DOTS

12. 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.

13. 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.

14. THANK YOU