## DOT: Core Strategy of NTEP **Key Point:** Directly Observed Therapy (DOT) is the cornerstone of NTEP. A trained health worker observes and confirms that the patient swallows each dose of anti-TB medication, ensuring adherence and preventing default. ### Primary Objectives of DOT 1. **Ensure 100% adherence** — Direct observation guarantees the patient takes the correct dose at the correct time. 2. **Prevent treatment default** — Reduces the risk of patients stopping therapy prematurely. 3. **Prevent drug resistance** — Incomplete or irregular therapy is the leading cause of MDR-TB; DOT prevents this. 4. **Monitor for adverse effects** — Health worker can identify and manage side effects in real time. **High-Yield:** DOT has been shown to increase cure rates from ~60% (self-administered) to >85% (DOT-supervised). It is mandatory for all TB patients under NTEP, not optional. **Clinical Pearl:** DOT is not punitive; it is a supportive mechanism. The observer (ASHA, ANM, or TB health worker) also provides counselling, monitors nutritional status, and ensures social support. **Mnemonic:** **DOT = Directly Observed Therapy** — "Directly" means the health worker sees the patient swallow; "Observed" means no room for default; "Therapy" means the entire treatment course is covered.
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