Directly observed treatment (DOT) means that a supervisor watches the patient swallowing the tablets. This ensures that a TB patient takes the right drugs, in the right doses, at the right intervals. DOT is applicable in outpatient settings. The supervisor may be a health worker or a trained and supervised member of the community.
DOT is recommended in the initial phase of treatment with FDCs, at least for all smear-positive cases, and in the continuation phase of rifampicin-containing (intermittent and daily) regimens. Patients' and health workers' compliance is a key factor in treatment success.
The use of FDCs will facilitate implementation of DOTS and must never be seen as a replacement for DOT.