Hurtig A K, Porter J D, Ogden J A
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK.
Int J Tuberc Lung Dis. 1999 Jul;3(7):553-60.
Directly observed therapy, short course (DOTS) is the current international strategy for controlling tuberculosis. Decisions have been taken internationally about the increasing tuberculosis epidemic-what to do and why to do it. But do we know bow the DOTS strategy can be implemented most appropriately and what changes need to be made to ensure that it is effective? This paper uses the Public Health/Human Rights framework to discuss TB control from a human rights rather than the biomedical perspective. The aim is to introduce different approaches to the current DOTS strategy in order to find more effective and appropriate ways to treat and care for people with tuberculosis. The paper argues that key dimensions of social, economic and physical access to TB services need to be assessed and accounted for in programme design. This will require that TB control adopt a wider interdisciplinary and multisectoral perspective to complement the current biomedical orientation.
直接观察短程治疗（DOTS）是当前控制结核病的国际战略。国际社会已就日益严重的结核病疫情做出决策——该做什么以及为何这样做。但我们是否知道如何最恰当地实施DOTS战略，以及需要做出哪些改变以确保其有效性？本文运用公共卫生/人权框架，从人权而非生物医学角度讨论结核病控制。目的是引入针对当前DOTS战略的不同方法，以找到更有效、更合适的方式来治疗和护理结核病患者。本文认为，在项目设计中需要评估并考虑获得结核病服务的社会、经济和实际途径的关键方面。这将要求结核病控制采取更广泛的跨学科和多部门视角，以补充当前的生物医学导向。
