TUBERCULOSIS

DOTS
Directly Observed
Treatment,
Short-course
 is the name given to the
World Health Organization
-recommended
tuberculosis control
strategy that combines
five components:
 Government commitment
(including both political
will at all levels, and
establishing a centralized
and prioritized system of
TB monitoring, recording
and training)
Case detection
by
sputum smear
microscopy
 Standardized
treatment regimen
directly observed by a
healthcare worker or
community health
worker for at least the
first two months
A regular
drug
supply
A standardized
recording and
reporting system
that allows
assessment of
treatment results
RECOMMENDED
CATEGORY OF
TREATMENT
REGIMEN
ISONIAZID (H)
RIFAMPICIN (R)
PYRAZINAMIDE (Z)
ETHAMBUTOL (E)
STREPTOMYCIN (S)
  Category 1
Type of TB patient Intensive Continua
phase tion
phase
• new smear-positive PTB 2HRZE
• new smear-negative PTB 4HR
with with extensive
parenchymal lesions on
CXR as assessed by the
TBDC
•EPTB, and
• severe concomitant HIV
disease
  Category II
Type of TB patient Intensive Continua
phase tion
phase
•treatment 2HRZ 5HRE
failure ES/
• Relapse 1HRZ
E
•Return after
default
•other
  Category III
Type of TB patient Intensive Continua
phase tion
phase
• new smear- 2HRZE 4HR
negative PTB ith
minimal
parenchymal
lesions CXR as
assessed by the
PTBC
  Category IV
Type of TB patient Intensive Continua
phase tion
phase
•Chronic (still Refer to
specialized
smear-positive facility or DOTS
after plus center
Refer to
supervised re- Provincial/City
treatment) NTP
Coordinator
  Categories I & III
Body weight No. of tablets No. of tablets
per day per day
Intensive phase Continuation
(2 months) phase (4
HRZE months) HR

30-37 2 2
38-54 3 3
55-70 4 4
>70 5 5
 Category II
Body Intensive phase Continuation
phase
weig First two months Third
ht
(kg) HRZE S
month
HRZE
HR E

30-37 2 0.75 g 2 2 1
38-54 3 0.75 g 3 3 2
55-70 4 0.75 g 4 4 3
>70 5 0.75 g 5 5 3