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Since most defaults happen in the first two months of treatment, weekly drug collection during the intensive phase is particularly important to identify potential defaulters.
The treatment regimen for Category 2 (retreatment TB patients) is: 2SRHZE/1RHZE/5RHE The intensive phase is therefore 3 months with daily injections of Streptomycin and swallowing of RHZE in the first two months and weekly drug collections in the third month, followed by 5 months of continuation phase with two weekly drug collections. The Division of Leprosy, Tuberculosis and Lung Disease (DLTLD), in line with international trends, has launched several new approaches to increase access to DOTS and truly expand population DOTS coverage.
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This is more critical in clients who have a cough, fever, weight loss, or have lymph node enlargement.
All HIV infected individuals should be screened for TB at initial enrollment into HIV care and at each clinical/ follow-up appointment.
These approaches include community based DOTS (CB-DOTS), Public-Private Mix for DOTS (PPMDOTS), collaboration between TB and HIV control programs and the development of an elaborate advocacy, communication and social mobilization strategy aimed at influencing communities to seek care early when TB symptoms occur and to remain on treatment until this is completed when treatment is initiated.
The delivery of DOTS services is integrated into the general health services provided at health care delivery points.
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All persons found to be HIV positive at HIV testing sites including VCT centers, STI clinics, PMTCT sites etc should be screened for TB and referred to the nearest TB diagnostic centres.
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