A DOTS-Plus Handbook Guide to the Community-Based Treatment of MDR TB

Publication date: 12/31/02
by Partners In Health, Harvard Medical School, Bill and Melinda Gates Foundation

Forms of tuberculosis untreatable with first-line drugs pose challenges quite unlike those posed by other resistant pathogens: an airborne bacterium, Mycobacterium tuberculosis is already a leading infectious cause of adult deaths in the world. In communities where MDR TB is already a public-health emergency,much can be done to turn the tide.

Effective therapy-based programs — “DOTS-Plus” — are an essential part of a humane response to suffering and will contain further spread. A DOTS-Plus Handbook: Guide to the Community-Based Treatment of MDR TB describes the approach taken by a transnational consortium of health workers constituted to respond to the problem of MDR TB in rural Haiti and urban Peru.This Handbook describes the technical framework and principles used to implement DOTS-Plus in resourcepoor settings. It also provides a number of case histories that illustrate common challenges in the treatment of MDR TB patients. Finally, the Handbook includes protocols that can be used under DOTS-Plus program conditions to manage common complication of this therapy. The principles outlined will be adaptable to other settings where DOTS-Plus interventions are necessary.

© Partners In Health, 2002

A DOTS-Plus Handbook Guide to the Community-Based Treatment of MDR TB
- Download the full manual in English (17.6 MB, PDF)