DOTS, which stands for Directly Observed Treatment, Short-course, is an initiative by the World Health Organization to greatly curb TB infection throughout the world by 2015. Japan is a participatory member and has a well-established system nation-wide (well at least in Osaka Prefecture) to help eradicate multi-drug resistant TB.
The program entails the administering of TB medication in front of a witness so that no doses are skipped or forgotten. Drug-resistant TB is formed when patients stop taking their medication early, before all of the bacteria can be successfully eradicated. The bacteria that do survive multiply with this new armor that regular drugs can’t penetrate, which can result in the disease being non-responsive to any type of medication. In extreme cases, patients can do nothing other than wait for death.
Here in Japan, all TB patients are given a small notebook where they can keep track of their progress. Nurses will, for the first month or so of treatment, directly observe patients taking their medication and will place their namestamp into the notebook next to the corresponding date. After a month, patients are trained to administer and keep track of their own medication. When discharged from the hospital, a health care worker will meet with the patient regularly to ensure that no doses are missed. Medication must be administered daily for at least 6 months to ensure that the disease is completely eliminated from the system.
DOTS notebook
TB'd in Japan 