Стратегия DOTS – путь к ускоренному излечению впервые выявленных больных легочным туберкулезом в России

DOTS strategy includes several important points, primarily, detection of tuberculosis patients and a strong monitoring of treatment efficacy. Specialists on lung tuberculosis from Tomsk have 5-year experience in work with DOTS programme. They observed 675 patients asked medical care in tuberculosis settings of Tomsk region from the March 1995 to November 1996. The patients ere divided into the group A and B. The group A received anti-tuberculosis therapy adopted in Russia. The group В was given directly observed treatment short course ( DOTS ) according to WHO standard. It included the intensive phase (2 months for new diagnosed cases and 3 months for repeated therapy course) and the continued phase of 2–4 (new diagnosed cases) to 5 months (repeated course) length. Typical WHO modes were used the first line drugs, such as isoniasid, rifampicin, pyrasinamid, etambutol, streptomycin. The therapy delayed results were assessed with criteria accepted by WHO and in Russia as well. Seventy one per cent of the patients recovered: 69% from the group A and 74% from the group B. The treatment failures were registered in 15 (4.2%) patients of the group A and 18 (5.6%) of the group B. Residual lesions of respiratory system were less severe in the group A patients just at the early period; there was no significant difference between the groups by the 30-th month of the observation. Meantime the cost-effectiveness of WHO standard treatment is 1.9 times less than that of Russian traditional schemes. Generally, a positive tendency in lung tuberculosis patients’ treatment and observation effectiveness has been noted in the Tomsk region for the last 5 years due to the DOTS strategy, so that it takes a positive role for tuberculosis patients’ cure.