DOTS and DOTS-plus: not the only answer.
Multidrug-resistant tuberculosis is already a global pandemic, with focal "hot spots" of ongoing transmission. Although DOTS (directly observed treatment, short course) chemotherapy is the goal of global tuberculosis control, short-course chemotherapy will not cure multidrug-resistant tuberculosis. In settings of high transmission of multidrug-resistant tuberculosis, "DOTS plus" (a complementary DOTS-based strategy with provisions for treating multidrug-resistant tuberculosis) is warranted. DOTS-plus project implementation to date reveals important clinical, epidemiological, and economic lessons. Community-based strategies designed to enhance local capacity are cost effective and make it possible to meet new medical challenges.
Farmer
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Infectious Disease Division, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. PIHPaul@aol.com
D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018432:Drug Resistance, Multiple; D006801:Humans; D010568:Peru / Q000453:epidemiology; D012426:Russia / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents