13.2.1 Self-administered treatment
Self-administered treatment (SAT) is taken autonomously by the patient without daily supervision. The patient is seen at a health facility at regular intervals (e.g. monthly) to receive drugs, support and treatment education. SMS telephone reminders may be considered to reinforce adherence.
13.2.2 Directly observed therapy
Drugs are sometimes provided daily to the patient and the treatment is taken under direct observation (DOT) by a third party.
DOT may be provided:
- In health facilities (facility-based DOT): in this model, DOT is implemented in a centralised setting and treatment is administered by healthcare workers.
- Outside of health facilities (community or home-based DOT): in this model, DOT is implemented in a decentralised setting and is usually provided by supervised, trained and remunerated treatment supporters.
For the roles and responsibilities of treatment supporters see Appendix 20.
- Remotely (video-observed therapy or VOT): VOT uses secure Internet connections via a smart phone or computer application to remotely supervise patients taking their treatment.
DOT is labour-intensive to implement and can be inconvenient for patients. Community and home-based DOT and VOT require fewer resources (personnel and transport) than facility-based DOT and may be more convenient for patients.
Drug-susceptible TB (DS-TB)
Drug-resistant TB (DR-TB)
Latent TB infection (LTBI)
- 1.Karumbi, J. and P. Garner. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev, 2015(5): p. CD003343.
- 2.Williams et al. Community-based management versus traditional hospitalization in treatment of drug-resistant tuberculosis: a systematic review and meta-analysis. Global Health Research and Policy (2016) 1:10