Scientific basis of directly observed treatment, short-course (DOTS)

The introduction of rifampicin, pyrazinamide and ethambutol ushered in the era of "short course chemotherapy". Multidrug resistance TB (MDR-TB) is threatening to destabilise the best efforts of TB control. Treatment of MDR-TB is difficult, expensive and toxic and is often unsuccessful. DOTS is an interventional strategy designed to effectively diagnose and treat TB. The fundamental principles in the DOTS strategy are: Polititical will, diagnosis by sputum microscopy, directly observed standardised short-course treatment, adequate supply of good quality drugs, systematic monitoring and accountability. Patients with HIV infection and TB disease respond well to antituberculosis treatment if they are given short-course chemotherapy in the programme of DOTS.