DOTS

DOTS (directly observed treatment, short-course), 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."

DOTS has five main components:

The technical strategy for DOTS was developed by Karel Styblo of the International Union Against TB & Lung Disease in the 1970s and 80s, primarily in Tanzania, but also in Malawi, Nicaragua and Mozambique. Styblo refined, “a treatment system of checks and balances that provided high cure rates at a cost affordable for most developing countries.” This increased the proportion of people cured of TB from 40% to nearly 80%, costing up to $10 per life saved and $3 per new infection avoided.

In 1989, WHO and the World Bank began investigating the potential expansion of this strategy. In July 1990, the World Bank, under Richard Bumgarner's direction, invited Styblo and WHO to design a TB control project for China. By the end of 1991, this pilot project was achieving phenomenal results, more than doubling cure rates among TB patients. China soon extended this project to cover half the country.

During the early 1990s, WHO determined that of the nearly 700 different tasks involved in Styblo's meticulous system, only 100 of them were essential to run an effective TB control program. From this, WHO's relatively small TB unit at that time, led by Arata Kochi, developed an even more concise "Framework for TB Control" focusing on five main elements and nine key operations. 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. In 1993, the World Bank’s Word Development Report claimed that the TB control strategies used in DOTS were one of the most cost-effective public health investments.

In the Fall of 1994, Kraig Klaudt, WHO's TB Advocacy Officer, developed the name and concept for a marketing strategy to brand this complex public health intervention. To help market "DOTS" to global and national decision makers, turning the word "dots" upside down to spell "stop" proved a memorable shorthand that promoted "Stop TB. Use Dots!"

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Wikipedia