DOTS-Plus

Abstract Multidrug-resistant tuberculosis (TB) is a major issue in global health, prompting concerns from multilateral agencies and donor organizations about the ability of low- and middle-income countries (LMICs) to effectively treat patients with this disease as a result of poor health infrastructure and the perceived inability to ensure that patients receive and take their specialized antibiotic regimens. The DOTS-Plus program for patients with drug-resistant TB described in this study provides individualized, patient-centered care in a community-based, outpatient, and low-resource environment. With this program, 83% of the patients completing at least 4 months of treatment achieved a probable cure. This study catalyzed changes to guidelines and practice of treating every drug-resistant case in an in-patient hospital setting and highlighted the limits of the standardized short-course approach to TB treatment.