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Satyamev Jayate Season 3 Episode 4: 5 reasons why DOTS system for TB treatment is incompetent

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Written By: Priyanka Ganwani | Updated : October 26, 2014 4:31 PM IST

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Satyamev Jayte 3 is out with its 4th episode, emphasising on India's biggest health problem: tuberculosis. Aamir Khan probed into the growing negligence in treatment of this disease not just in the public healthcare sector but also in private hospitals. He spoke of various causes and loopholes in medication and treatment that may prove fatal for the patient. An important aspect for treating and curing this disease is the Directly Observed Treat Short-course (DOTS) system. It is a government program aimed at working on treatment for patients suffering from TB. As the name suggests, it is meant to prove as a one-stop for TB treatment related guidance that could be provided to as may patients.

Large number of deaths are caused due to ineffective treatment. Hence, the DOTS system needs some immediate improvements. Here are 5 drawbacks and reasons why the DOTS treatment system is not as effective as expected:

Inconsistent treatment
The TB medicine dosage is spread out every alternate day and not every day. This may lead to unwanted antibiotic resistance, prolonging or in some cases being ineffective in treating the disease.
No transparency in treatment
As a government commitment to public health and healthcare in India, the medications are to be free of cost and not charged for. As a result of which those unable to meet with the basic needs are in a helpless situation as they are bribed and forced to shell out more money for their drug supplies. Corrupt DOTS providers demand for exorbitant amounts of money or turn down patients if they are unable to pay.
No follow-up
The most crucial aspect of this treatment system to help cure such patients is by consistent and stringent intake of prescribed medicines. Lack of timely intake or supervision on the consumption of the medication has high chances of worsening the situation. The TB bacteria may grow ineffective to medication which could prove fatal. This also means, there is a need to update the patient sheet with timely checks and tests about the worsening condition so as to increase medication accordingly.
Inconvenient time
There are DOTS provider centers all over the country, however the patient may still be deprived of the services and treatment provided. This is so because these centres only run during the morning working hours of 9 am-2 pm, which proves to be inconvenient for those heading to work during those hours. Changes are to be made by the state-run centres to increase the number of cured patients and prove as beneficial to them.
Loopholes in tracking patient's medical records
As the treatment program progresses in the course of time, it is crucial to keep a track of the TB patient's medical reports. Regular checks have to be undertaken if a case seems incomplete or if the centre has not heard from the patient, unexpectedly. It is to be verified that the patient has fully recovered or is in a worsened condition. Know more on how TB is affecting India's health, here.
Additionally, here are further challenges that India is facing with the treatment of TB:
Delayed diagnosis

Early diagnosis is an essential element to early control of the any infectious disease. In case of tuberculosis, the organism (Mycobacterium tuberculosis) causing the disease has the ability to remain latent in the infected person without causing active TB disease. Such patients are carriers of TB bacteria which can be transmitted to healthy individuals, thereby increasing the number of TB carries and active TB cases.

Also Read

Patient non-compliance to TB treatment

Both the experts highlight the role of patient non compliance as a barrier to successful TB treatment. Consultant physician Dr Pradip Shah, Fortis Hospital, Mulund, Dr Shah says Minimum treatment period of TB disease is 6-9 months. However, patients who start feeling better within 2 months of taking drugs discontinue the treatment. This is one of the main pitfalls that we are facing in India.

Lack of patient counselling

In India, a lot of people from rural areas suffer from TB. They don t know the dangers of the disease and that they could be potent carriers of TB causing bacteria. Further people who diagnosed with TB don t know the details like dosage, duration of treatment etc. Read more here.

Image source: Getty Images

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Priyanka Ganwani

Priyanka Ganwani

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