Can directly observed treatment scheme (DOTS) be modified for childhood tuberculosis

represent between 5 - 15 % of all tubercular diseases. There are about 1.3 million cases of childhood tuberculosis occurring in the world annually and approximately 450000 deaths every year. The incidence has gone up even in the developed countries due to immigration from high prevalence areas emergence and spread of HIV infection; HIV related TB and multi-drug resistance TB and gradually deteriorating economy of the world. DOTS is a WHO sponsored strategy to combat this killer disease - the strategy is to provide short-course chemotherapy under direct observation to all patients especially smear positive cases. DOTS ensures compliance correct treatment protocol and regular follow up. The provision of short-course chemotherapy is one of the most cost-effective of all health interventions. The aim is to achieve targets of 85% cure rate and 70% case detection rate. But this scheme is mainly adult oriented and since the advent of HIV and multi-drug resistance TB morbidity from childhood TB is rising at an alarming rate. Children form rural community background find it difficult to attend a paediatric centre for regular treatment and follow up. DOTS is to be offered to them at the doorstep of the community. There is a fervent need to modify DOTS to suit childhood tuberculosis. (excerpt)