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DOTS Sure cure for TB

Dr. K.N. Gupta, MD (Chest and TB)

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DOTS – Direct Observation Treatment Short course

Short Course chemotherapy under Direct Observation, It is the internationally accepted treatment strategy for sure cure of tuberculosis. Under Revised National Tuberculosis Control Programme (RNTCP) which is technically supported by WHO and recommended by Government of India, DOTS is a comprehensive public health strategy of control TB. It reliably increases cure rates, decreases the proportion of patients who die and prevents the further emergence of drug resistance.

Rajasthan has accomplished the fastest expansion of RNTCP ever documented with high Cure Rate of 85 per cent in new smear +ve cases and 70 per cent Case Detection Rate.

Role of Private Health Care Provider

Private practitioners are generally the first point of contact for significant proportion of patients with tuberculosis. Hence, the role of private practitioner is very important for effective implementation of programme.

Factors favouring Private Health Care Provider (PPs) role are.

  • Convenient consultations
  • Timings and locations of private facilities are patient friendly
  • Early initiation of treatment
  • Physicians flexibility towards concerns of patients.
  • Maintenance of secrecy of disease.

Under RNTCP guidelines of Central TB Division, involvement of PPs (Consultants, Nursing Homes, Hospitals) can be under various schemes

Schemes for Collaboration with PPs

Scheme 1 Referral of chest symptomatics 3 Yrs
Scheme 2 Provision of Directly Observed Treatment 3 Yrs
Scheme 3 A Designated Paid Microscopy Centre, Microscopy only 1 Yr
Scheme 3 B Designated Paid Microscopy Centre, Microscopy and Treatment 1 Yr
Scheme 4 A Designated Microscopy Centre, Microscopy only 1 Yr
Scheme 4 B Designated Microscopy Centre, Microscopy and Treatment 1 Yr

NGO’s can also participate in RNTCP in collaboration with Public Health Care Providers under various schemes meant for them. Under these schemes commodity assistance and Grant – in – Aid is provided, Training and Monitoring is done by DTC as per guidelines of Government.

Approval and registration under various schemes can be done by DTC officials to be renewed annually on basis of satisfactory annual reports of activities, evaluation of performance by DTC and recommendations for extension. In case of poor performance and non-diligence, the contract can be terminated at anytime without prior notice.

As TB is a major health problem in India, the public-private mix partnership in RNTCP can play a vital role for successful implementation of programme.

PPM Structure in Jaipur

DMHS, Government of Rajasthan, Jaipur. Ph.2570839 R)


DMHS, Government of Rajasthan, Jaipur

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