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

Publication date December 31, 2002
by Partners In Health, Harvard Medical School, Bill and Melinda Gates Foundation

PIH Guide to the Medical Management of Multidrug-Resistant Tuberculosis

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)

Chapter 1.
565 KB
Why DOTS-Plus for MDR TB? An Introduction
Chapter 2.
122 KB
Why a DOTS-Plus Handbook? Building on Experience
Chapter 3.
3.82 MB
Starting DOTS-Plus: Laying the Groundwork
Chapter 4.
3.23 MB
Identifying and Evaluating Patients
Chapter 5.
5.16 MB
Therapy for MDR TB
Chapter 6.
4.61 MB
Treatment Surveillance
Chapter 7.
185 KB
Management of Adverse Effects: A Cornerstone of DOTS-Plus Treatment
Chapter 8.
89.7 KB
Evaluation of Program
47.8 KB
Notes to Chapters
102 KB
444 KB
Appendices Appendices Table of Contents
56 KB
General Guidelines
167 KB
255 KB
Forms for Data Surveillance
238 KB