In any given year, hundreds of tuberculosis cases are reported to the County of San Diego Tuberculosis Control Program. An airborne disease, tuberculosis (TB) can spread to others who have prolonged contact with someone suffering from TB disease.
One way to control the spread is to make sure everyone diagnosed with TB is on the right medicine and remains on them until cured. To do this, the County offers the Directly Observed Therapy (DOT) Program. In DOT, public health nurses and outreach workers monitor patients regularly to make sure they are taking their medications as directed.
“We would go to your home, or to your work, wherever it’s convenient for you, and actually observe you taking your medicine,” said Kathleen Moser, M.D., Chief, County TB Control. “ Just to give you support, make sure you’re taking (all your pills), and make sure you’re taking them the right way.”
The DOT program safeguards public health by ensuring patients complete their treatment and become non-infectious as rapidly as possible. It is also intended to help prevent TB transmission and keep the disease from becoming drug-resistant. DOT is recommended by the Centers for Disease Control and Prevention (CDC) as the program proven to result in higher rates of treatment completion.
The service is without charge and is provided to all physicians and their patients throughout the County. DOT starts with a visit from a public health nurse who brings the patient’s TB medication in a locked box that remains with the patient. The nurse also answers questions about the disease, treatment and medication.
Next, a trained outreach worker visits the patient to make sure the affected individual takes all the prescribed medications during the visit. The visits continue until the patient is cured of TB, which can take six to 24 months.
“We don’t want (patients) to stop taking their medication and reactivate the disease,” said Maricela Fregoso, a County TB outreach worker. “Then it could become resistant to the medication and it could become worse.”
Jason (no last name) was diagnosed with tuberculosis and recently completed treatment for the disease, which included home isolation.
“You never think you’ll get TB until you actually do. It does not discriminate,” he said. “As long as you take your pills every day and make sure you keep up with it, you can get rid of it.”
Tuberculosis is not uncommon in the San Diego region. In 2007, there were 280 total cases of tuberculosis in San Diego County.
Symptoms of active TB include persistent cough, fever, night sweats and unexplained weight loss. Most people who are exposed to TB do not develop the disease.
People who are experiencing the above symptoms of TB are strongly encouraged to contact their health provider.
For more information about the Directly Observed Therapy Program, please call the HHSA Tuberculosis Control Program at (619) 692-5668 or visit the Tuberculosis Control Program Web site.