Directly observed treatment, short-course
DOTS, also known as TB-DOTS, is the name given to the tuberculosis control strategy recommended by the World Health Organization. According to WHO, "The most cost-effective way to stop the spread of TB in communities with a high incidence is by curing it. The best curative method for TB is known as DOTS."
What is directly observed therapy?
Directly observed therapy (DOT) is used to ensure the person receives and takes all medications as prescribed and to monitor response to treatment. DOT is widely used to manage tuberculosis (TB) disease. In HIV treatment, DOT is sometimes called directly administered antiretroviral therapy (DAART). Directly Observed Therapy (DOT) | NIH
What is direct observation therapy for tuberculosis (TB)?
The initial emphasis was on "DOT, or directly observed therapy, using a specific combination of TB medicines known as short-course chemotherapy as one of the five essential elements for controlling TB.
What is DOTS (Directly Observed treatment)?
Directly observed treatment, short-course (DOTS, also known as TB-DOTS) is the name given to the tuberculosis (TB) control strategy recommended by the World Health Organization. According to WHO, "The most cost-effective way to stop the spread of TB in communities with a high incidence is by curing it.
What is a directly observed therapy lay worker?
DOT Lay Worker Lay person or health professional who takes on the role of giving Directly Observed Therapy medication. Enzymes A substance produced by the body which acts as a helper to promote a specific biochemical reaction.
What is the meaning of direct observed treatment?
A method of drug administration in which a health care professional watches as a person takes each dose of a medication. Directly observed therapy (DOT) is used to ensure the person receives and takes all medications as prescribed and to monitor response to treatment.
WHO directly observed therapy?
Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose.
What is Dot CDC?
Directly observed therapy (DOT) is a key element of TB case management. Endorsed by the World Health Organization and CDC, DOT entails a trained observer watching as the patient swallows the anti-TB medications.
What is TB DOTS program in the Philippines?
The Lung Center of the Philippines TB DOTS Clinic caters to adult afflicted with TB since early 2000 and children with TB in 2007. It is the first public health facility engaged in implementing Programmatic Management for Drug resistant TB in 2005 as a satellite treatment center under the Green Light Committee.
What is TB DOT test?
TB test (T-Spot). A health care provider will draw a patient's blood and send it to a laboratory for analysis and results. Positive TB blood test: This means that the person has been infected with TB bacteria. Additional tests are needed to determine if the person has latent TB infection or TB disease.
What is directly observed therapy in Singapore?
Tuberculosis treatment – Directly Observed Therapy (DOT) Called Directly Observed Therapy (DOT), the treatment requires patients to go to a clinic daily or three times a week and take their medicine (about 11 tablets initially) in front of a health care worker, most often a nurse. The process is rather quick.
Why directly observed treatment is necessary?
DOT helps patients finish TB therapy as quickly as possible, without unnecessary gaps. DOT helps prevent TB from spreading to others. DOT decreases the risk of drug-resistance resulting from erratic or incomplete treatment. DOT decreases the chances of treatment failure and relapse.
What are the five main components of DOTS?
Abstract. Directly Observed Therapy Shortcourse (DOTS) is composed of five distinct elements: political commitment; microscopy services; drug supplies; surveillance and monitoring systems and use of highly efficacious regimens; and direct observation of treatment.
Which drugs are given in DOTS?
DOTS involved treatment with a four drug regimen. These were isoniazid (INH), Rifampicin (Rif), Prazinamide (PZA) and Ethambutol (EMB) for 6-9 months.
Is tuberculosis covered by PhilHealth?
WITH the rising number of tuberculosis cases noted in the country, the Philippine Health Insurance Corporation (PhilHealth) today reminded members that treatment for pediatric and adult tuberculosis is covered through its outpatient Directly-Observed Treatment Short-course DOTS) Package.
How long is TB treatment Philippines?
A TB patient requires a daily treatment regimen that lasts for six to nine months. Patients are encouraged to go to TB clinics to take their medicines, under the care of a designated health worker.
What is Dot treatment tuberculosis?
Directly Observed Therapy (DOT) is a technique of delivering TB treatment to ensure timely completion of treatment, prevent further TB transmission, and prevent development of drug resistance. National guidelines recommend DOT as standard treatment for TB disease.
What is SOA evaluation?
By the Office of Program Consultation and Accreditation. The Standards of Accreditation (SoA), launched in 2017, introduced a new requirement that evaluations of students and trainees at all levels be based on direct observation of evaluated competencies. Direct observation, as it came to be known, was further explained in a series ...
Where to refer questions about direct observation?
Additional questions about direct observation should be referred to the Office of Program Consultation and Accreditation.
Do you need direct observation for a doctoral program?
Doctoral and internship programs are not required to provide direct observation of all the profession-wide competencies; however, direct observation should cover a sufficient variety of activities and competencies to meaningfully contribute to performance evaluations of trainees.
Do you have to complete direct observation for each practicum?
At the doctoral level, direct observation must be completed for each evaluated practicum. If several practica are completed and evaluated in a single semester, it is expected that each evaluated experience would include at least one single instance of direct observation.
Who can provide direct supervision?
Direct supervision can be provided by doctoral-level psychologists and also by other supervisors who are appropriately trained, credentialed and prepared in their discipline and in the health service psychology activities being supervised. This correction has been incorporated above.
Who do programs consult with?
Programs regularly consult with the Office of Program Consultation and Accreditation about issues related to direct observation, and this article addresses some of the most frequently encountered questions.
Why is ethambutol included in the regimen?
Ethambutol is included in the regimen in the event that drug resistance is later detected from the tuberculosis culture. If the offending organism is known to be susceptible to all antituberculous medications then ethambutol can be excluded.
What should be included in a DOT monitoring?
Standard monitoring for tolerance and response to therapy beyond DOT should include monthly standardized symptom evaluation, weight check, comprehensive metabolic panel and complete blood count, thyroid-stimulating hormone and/or thyroxine levels ( if the patient is receiving ethionamide or para-aminosalicylate), assessment of visual acuity and color discrimination ( if receiving ethambutol), audiogram and vestibular assessment (while receiving injectable agents), and periodic (e.g., quarterly) radiographic examination. For patients with pulmonary disease, serial sputum examinations should be conducted (e.g., weekly until smear negative, then monthly through the end of treatment). For extrapulmonary tuberculosis, mycobacteriologic monitoring is not feasible, warranting greater attention to clinical and radiographic responses to therapy. Experts disagree on the benefit of routine pharmacokinetic studies to evaluate drug absorption and targeted blood levels, but there is greater support for its use in the context of treatment failure. In practice, these studies tend to be limited to patients with suspected malabsorption (e.g., HIV enteropathy, inflammatory bowel disease, diabetic enteropathy), drug-drug interactions that result in suboptimal serum levels of antituberculosis drugs, treatment failure in the absence of drug resistance, and use of particular agents (e.g., cycloserine).
How often do you give rifampin for tuberculosis?
Tuberculosis treatment is usually given daily at the initiation of therapy. After 2 months of therapy most patients are receiving only two medications, INH and rifampin. These medications can be given on an intermittent schedule, either two or three times a week.
What is 72,90 dot?
In the UK, where tuberculosis is (or should be) treated by experienced physicians working in direct conjunction with tuberculosis nurses or health visitors 24 and as part of a district plan, 72,90 DOT is recommended for selective use in people with an adverse adherence assessment.
Why should a small percentage of naturally occurring tuberculosis bacilli be used?
Because a small percentage of naturally occurring tubercle bacilli will have inherent resistance to various tuberculous medications, at least two medications to which the bacilli is susceptible should always be used. It is a central tenet of tuberculosis therapy not to add a single drug to a failing regimen as it can lead to further resistance and treatment failure.
How did the discovery of tuberculosis affect the lives of millions of people?
The discovery and widespread use of these drugs dramatically changed the lives of millions of people. The tuberculosis sanatorium, which offered patients the comfort of bed rest and helped diminish tuberculosis transmission in the community, long the only hope for many patients, soon became obsolete.
How often should a sputum be screened for pulmonary disease?
For patients with pulmonary disease, serial sputum examinations should be conducted (e.g., weekly until smear negative, then monthly through the end of treatment). For extrapulmonary tuberculosis, mycobacteriologic monitoring is not feasible, warranting greater attention to clinical and radiographic responses to therapy.
