WHO evolved "DOTS" for the effective control of?

SCTIMST Staff Nurse - 2015 (Set-B)

Community Health Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-B)

Explanation

DOTS, which stands for Directly Observed Treatment, Short-course, is a globally recommended strategy by the WHO specifically for the control of Tuberculosis (TB).
The core principle of DOTS is to ensure complete adherence to the lengthy anti-TB treatment regimen, thereby increasing cure rates and preventing the emergence of drug-resistant TB.
This is achieved through direct supervision, where a healthcare worker or a trained volunteer watches the patient swallow each dose of medication during the initial, intensive phase of treatment.

Option A: Leprosy is primarily managed with Multi-Drug Therapy (MDT), a specific combination of antibiotics, but this regimen is not administered under the DOTS framework.
Option C: Poliomyelitis is a viral disease that is prevented through vaccination (Oral Polio Vaccine and Inactivated Polio Vaccine), not treated with a drug therapy regimen like DOTS.
Option D: Malaria control involves a combination of vector control (e.g., mosquito nets), prevention, and treatment with antimalarial drugs like Artemisinin-based Combination Therapy (ACT), not a directly observed strategy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain DOTS strategy for Tuberculosis control as background academic context rather than a clinical decision trigger.
Nurses are pivotal to the success of the DOTS program, often serving as DOTS providers who educate patients, ensure adherence, and build a trusting relationship with the patient and their family.
A critical nursing responsibility is to monitor patients for adverse effects of anti-TB drugs, such as hepatotoxicity (from isoniazid, rifampicin, pyrazinamide), peripheral neuropathy (from isoniazid), and ototoxicity (from streptomycin).
What if? If a patient on DOTS develops jaundice (yellowing of skin and eyes), the nurse must immediately recognize this as a sign of severe hepatotoxicity. The standard action is to stop the medication, notify the physician immediately, and arrange for urgent liver function tests.

How to Approach the Question

This is a factual recall question common in community health nursing.
Identify the key acronym in the question: 'DOTS'.
Recall or deduce the full form: 'Directly Observed Treatment, Short-course'.
Analyze the meaning: The term 'Directly Observed' implies a strategy to ensure patients take their medicine, which is critical for diseases requiring long-term treatment where non-adherence is a major problem.
Evaluate the options. Tuberculosis is famous for its long treatment duration (6 months or more) and the high risk of developing drug resistance if treatment is incomplete. Therefore, a strategy to ensure adherence is most logically applied to TB.
Eliminate other options based on their primary control methods: Leprosy (MDT), Polio (Vaccination), and Malaria (Vector control/Antimalarials).

Concept Tested & Keywords

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) pp. 93-95, 21-23

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