Beyond DOTS (Directly Observed Treatment Short-Course) in tuberculosis' control: interfacing and sharing needs

This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of São Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the health-disease process including the treatment and life projects of patients with tuberculosis.