Is the directly observed therapy short course (DOTS) an effective strategy for tuberculosis control in a developing country?

Tuberculosis is the leading cause of death due to an infectious agent; it is both preventable and treatable[1]. Globally, there are more cases of tuberculosis today than in previous epochs of human history. Tuberculosis and human immunodeficiency virus (HIV) co-infection and increasing multi-drug resistance is greatly responsible for tuberculosis assuming almost epidemic proportions[2-4]. It affects one third of the world’s population of well over 6 billion people, and 8.8 million people develop active disease each year[5]. Globally, tuberculosis causes about 2 million deaths yearly[6,7]. In response to this catastrophe, the World Health Organisation’s (WHO) global tuberculosis programme in 1993 declared tuberculosis a global emergency and began promoting a management strategy called directly observed therapy short course (DOTS). By 2005, 187 countries had started implementing DOTS with 4.9 million cases of tuberculosis being treated using DOTS in that year alone[8].