DIRECTLY OBSERVED TREATMENT (SHORT COURSE) STRATEGY "DOTS"

1. DOTS supporters for TB cases are as near to the home of cases as is convenient to ensure regular treatment and periodic clinic supervision.

2. Community supporters of DOTS will have:

2.1 a box in which to store the supply of drugs specific for each patient being supported,
2.2 a supply of green cards for recording (as a duplicate) the treatment given while the patient keeps the original card issued by the clinic,
2.3 patient education material in the correct language.

3. All community DOTS supporters have received a course of training equivalent to at least one week, either continuous or in sessions.

4. Training covers knowledge, attitude change and skills in communication, simple counselling and problem solving in providing correct continuous directly observed treatment.

5. Suitable training manuals and health learning materials are provided.

6. DOTS supporters in the community receive supportive supervision by regular contact with the clinic nurse who will also record continuity of progress in the clinic TB register.

7. Success is measured by recording:

7.1 The number of missed treatments and
7.2 The rapidity of re-establishing continuous treatment and sputum conversion at 2 months for new cases and 3 months for re-treatment cases and at 6 months and 8 months for new and re-treatment cases respectively.
7.3 % of patients on DOT.
7.4 smear conversion rate at 2/3 months of treatment.
7.5 % of patients who are cured.

8. The community health committee participates in identifying new potential DOTS supporters. This is a partnership between supporter, patient and clinic with the patient deciding who his supporter will be.

9. Committees may provide non-financial incentives such as community recognition of outstanding voluntary DOTS support.

10. All referrals and transfers of community based DOTS patients are documented on the correct forms and followed up by the referring or transferring health facility.