TUBERCULOSIS (TB) is man’s oldest infectious killer. TB is a disease that usually attacks and lays waste to the lungs, but it can spread to other areas of the body, particularly the brain, the kidneys, and the bones. Tuberculosis of the lungs can cause coughing, loss of weight and appetite, severe sweating at night, weakness, shortness of breath, and chest pains.
Now the Good News about Tuberculosis
Today, however, there is hope. After ten years of testing, researchers have come up with a strategy that may reduce tuberculosis from being a killer on the loose to being a criminal under siege. Dr. Hiroshi Nakashima, former director-general of World Health Organization (WHO), called this new strategy “one of the most important public health breakthroughs of this decade.” And Dr. Arita Kochi, director of the WHO Global TB Program, says that it offers the first-ever chance to “reverse the TB epidemic.” The cause of all this excitement? A method called DOTS.
DOTS is an acronym for directly observed treatment, short-course. It is a health management system that can cure most TB patients in six to eight months without their spending a single day in the hospital. DOTS depends on five elements for its success. If any of the elements are missing, notes WHO, the ability to cure TB victims “slips through our fingers.” What are these elements?
- 1. Directly: The most dangerous TB case is the diagnosed case. WHO thus stresses that first of all, health-care workers should direct their efforts to identifying the people in their community who suffer from contagious TB.
- 2. Observed: The second element of DOTS makes the health system—not the patient—responsible for achieving a cure. Health-care workers or trained volunteers, such as shopkeepers, teachers, or former TB patients, observe patients swallowing each dose of anti-TB medicines. “Patient observers” are crucial for success because a main reason why TB persists till today is that patients stop taking their medicines too soon. After just a few weeks of medication, they start feeling better and stop taking their pills. Yet, the medication must be taken for six to eight months in order to rid the body of all TB bacilli.
- 3. Treatment: During these six to eight months, health workers monitor the results of the treatment and document the patients’ progress. In that way, they make sure that patients are fully cured and cannot pass the infection on to others.
- 4. Short-Course: Using the right combination and the right amount of anti-TB drugs, known as short-course chemotherapy, for the right length of time is the fourth element of the DOTS strategy. These combined drugs give a knockout punch to kill the TB bacilli. The drugs must always be in supply so that treatment is never interrupted.
- 5. !: WHO expresses this fifth element of the DOTS strategy by means of an exclamation mark at the end of DOTS! It represents funding and sound policies. WHO urges health systems to secure financial commitment from governments and nongovernmental organizations and to make TB treatment part of the country’s existing health system.