DOTS strategy helping to lower TB rate, CDC says

PATIENT CARE::Having carers personally deliver the medication and directly observe patients taking the drugs has improved TB treatment, the center said

By Alison Hsiao  /  Staff reporter

Sat, Sep 28, 2013 - Page 3

Implementation of the WHO’s directly-observed treatment, short-course (DOTS) strategy for tuberculosis (TB) since 2006 has helped reduced the prevalence of the disease in Taiwan by 26.9 percent, the Centers for Disease Control (CDC) said yesterday at a national conference on the effectiveness of the strategy and related policy changes in Miaoli County.

The program has reduced TB rates from 72.5 cases per 100,000 people in 2005 to 53 cases per 100,000 last year, CDC data showed.

The relapse rate in the two years after treatment completion also declined from 1.8 percent in 2005 to 0.7 percent in 2010, the data showed.

DOTS is not limited to supervised treatment by local health authorities to ensure that patients take their medication regularly and complete their treatment, but is also a program that places a high value on “patient-centered” care and support, the agency said.

Since tuberculosis usually takes at least six months to treat, people with TB tend to forget to take their drugs regularly or quit therapy when their symptoms are relieved, the CDC said.

Some also drop out of the program because of the side-effects of the numerous drugs they have to take, or because they become resistant to the drugs, the center said.

The CDC said it has been subsidizing local health authorities in hiring DOTS carers since 2006, spending about NT$400 million (US$13.49 million) per year. There are about 700 DOTS carers in the nation working in local health agencies’ public health nurses.

Having carers personally deliver the medication and directly observe patients taking the drug has helped improve the success rate of the treatment, prevent drug resistance and stop the spread of the disease in the community, the CDC said.

More than 90 percent of people with sputum smear-positive TB are participating in the DOTS program, with carers visiting them to give them drugs five days a week, the center said.