Directly observed treatment for tuberculosis

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7419.823 (Published 09 October 2003) Cite this as: BMJ 2003;327:823
  1. Paul Garner, head (pgarner@liv.ac.uk),
  2. Jimmy Volmink, professor (jvolmink@cormack.uct.ac.za)
  1. International Health Research Group, Liverpool School of Tropical Medicine, Liverpool L3 5QA
  2. Primary Health Care, Faculty of Medical Sciences, University of Cape Town, Observatory 7925, Cape Town, South Africa

    Less faith, more science would be helpful

    Drugs cure tuberculosis. So why does the disease remain in the top 10 causes of global mortality, with 1.8 million deaths a year?1 Most deaths are in low and middle income countries, where a major challenge is to ensure that drugs are available and people complete the long treatment. The World Health Organization has been tackling the global problem of inadequate tuberculosis control for some years and launched a new programme of integrated care in 1994, called directly observed treatment, short course (DOTS).2 By using a six month course of drugs, including rifampicin, WHO has mobilised money, people, and systems in countries to tackle the global problem with good progress.3 Its strategy is divided into five key aspects: political commitment, access to sputum microscopy, short course chemotherapy using direct observation …

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