When treating persons with active TB disease, our country has adopted a system called DOT, which stands for directly observed therapy. This system helps TB patients to comply with the prescribed schedule of taking their medication.
It is especially critical for people living with medicine resistant TB, HIV infection, and those who have to take medicine intermittently, say 2 or 3 times a week.
In effect, DOT means that a trained health care worker or other designated individual (excluding a family member) provides the prescribed TB medication and watches the patient swallow every dose.
Benefits of DOT
Some people are more lax in taking their medication as prescribed. It cannot be predicted who will take medications as directed, and who will not. Social class, education, age, gender or ethnic group plays no role. However, where DOT is followed, the following happens:
- 86 to 90% of people complete the therapy, compared to 61% for those who are not on the system
- People finish TB therapy as quickly as possible, without unnecessary gaps
- The spread of TB to others is prevented
- The risk of medication resistance as a result of erratic or incomplete treatment is decreased
- The chances of treatment failure and relapse are decreased.
Provision of DOT
The following individuals and organisations can provide DOT:
- A nurse or supervised outreach worker from the person’s district public health department normally provides DOT
- In some situations, it works best for clinics, home care agencies, correctional facilities, treatment centres, schools, employers and other facilities to provide DOT, under the guidance of the local health department
- Family members should not be used for DOT. DOT providers must remain objective
- For complex or intensive treatment plans, home care agencies may provide DOT or share responsibilities with the local health department
- If resources for providing DOT are limited, priority is given to individuals most at risk.
The provision of DOT includes:
- Delivering the prescribed medication
- Checking for side-effects
- Watching the person swallow the medication
- Documenting the visit
- Answering questions.
DOT usually starts at the beginning of TB treatment.
Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about DOT treatment for TB. Call us on our EWP number or email us at
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