Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 9984
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents 
Year : 2015  |  Volume : 4  |  Issue : 1  |  Page : 152-153  

Video directly observed treatment: How effective will it be in indian setting?

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Date of Web Publication27-Feb-2015

Correspondence Address:
Anindo Majumdar
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry - 605 006
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4863.152279

Rights and Permissions

How to cite this article:
Majumdar A, Sujiv A, Palanivel C. Video directly observed treatment: How effective will it be in indian setting?. J Family Med Prim Care 2015;4:152-3

How to cite this URL:
Majumdar A, Sujiv A, Palanivel C. Video directly observed treatment: How effective will it be in indian setting?. J Family Med Prim Care [serial online] 2015 [cited 2021 Sep 16];4:152-3. Available from: https://www.jfmpc.com/text.asp?2015/4/1/152/152279

Dear Editor,

The Directly Observed Treatment, Short-course (DOTS) strategy for control of tuberculosis (TB) in India requires the patient to take drugs in presence of a DOTS provider. Though this enhances treatment completion rates and reduces chance of drug resistance, it sometimes becomes difficult for the patients because of job requirements, lack of transport facilities, and stigma associated with the disease. From the health system's perspective also, it may be demanding in terms of time, financial incentives and travel costs of the DOTS provider.

In India, significant proportions of TB patients receive treatment from the private sector. A study from Andhra Pradesh reported that only 21% private practitioners had practiced DOT or used other enablers during the course of treatment. [1] There is a dearth of human resources in the Government of India's Revised National Tuberculosis Control Program (RNTCP) as well. For instance, out of the 693,628 DOTS provider posts sanctioned under RNTCP, only 68% are in place and have received training. [2] Thus, it is imperative to look for alternate newer and innovative mechanisms for DOTS provision to complement the existing DOTS strategy, especially in resource poor settings like India.

A pilot study conducted in Kenya to study the feasibility of using multimedia messaging service (MMS) to monitor the drug intake in TB patients has shown promising results. [3] A person close to the patient (called patient assistant) was trained in recording videos of the patient, while swallowing the drug and sending it to the drug provider using a MMS-enabled mobile phone. In a similar study in the United States, the cost-effectiveness of videophone technology in DOT provision was higher when compared to in-home DOT, with an average cost savings per patient of US $2448. [4]

Other aspects of mobile DOT (MDOT), such as short message service have been previously explored mainly for propagating health messages or for sending medication reminders. By enabling patients to send videos at any time, and from any location through their mobile phones, video DOT (VDOT) allows patients to take the medications on a schedule that better suits their lifestyle, thus resulting in better treatment compliance. The advantage for health system is cost-effective supervision.

India has the second-largest mobile phone user base in the world (with over 900 million users). [5] Though this is an opportunity for advancement of MDOT services, information regarding number of mobile phones with MMS facility is lacking. Requirement of training for recording and sending MMS videos is a challenge. Others include issues of poor cellular network in hard-to-reach areas, data security, back-up, and large data storage requirements in phones.

Pilot studies are required to explore future possibilities of utilizing VDOT for TB control in India. Initial studies might focus on its utility for TB patients who have specific time or travel constraints, if not for all. Collaboration between RNTCP and the Information Technology sector can bring in innovations like specially made low cost MMS-enabled mobile phones. Considering increase in mobile phone usage and shortage of manpower in the program, VDOT appears to be a viable alternative in selected group of patients.

  References Top

Achanta S, Jaju J, Kumar AM, Nagaraja SB, Shamrao SR, Bandi SK, et al. Tuberculosis management practices by private practitioners in Andhra Pradesh, India. PLoS One 2013;8:e71119.  Back to cited text no. 1
TB India 2013. Revised National TB control Programme. Annual Status Report. Central TB Divsion. Directorate General of Health Services. Ministry of Health and Family Welfare, Government of India. Available from: http://www.tbcindia.nic.in/pdfs/tb%20india%202013.pdf. [Last accessed on 2014 Jan 11].  Back to cited text no. 2
Hoffman JA, Cunningham JR, Suleh AJ, Sundsmo A, Dekker D, Vago F, et al. Mobile direct observation treatment for tuberculosis patients: A technical feasibility pilot using mobile phones in Nairobi, Kenya. Am J Prev Med 2010;39:78-80.  Back to cited text no. 3
Krueger K, Ruby D, Cooley P, Montoya B, Exarchos A, Djojonegoro BM, et al. Videophone utilization as an alternative to directly observed therapy for tuberculosis. Int J Tuberc Lung Dis 2010;14:779-81.  Back to cited text no. 4
India is the Second-Largest Mobile Phone user in World. Press Information Bureau. Ministry of Health and Family Welfare. Government of India, 2012, Aug 02. Available from: http://www.pib.nic.in/newsite/erelease.aspx?relid=85669. [Last accessed on 2014 Jan 09].  Back to cited text no. 5

This article has been cited by
1 Mobile Health for Tuberculosis Management in South India: Is Video-Based Directly Observed Treatment an Acceptable Alternative?
Anil A Kumar,Ayesha De Costa,Arundathi Das,GA Srinivasa,George DęSouza,Rashmi Rodrigues
JMIR mHealth and uHealth. 2019; 7(4): e11687
[Pubmed] | [DOI]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article

 Article Access Statistics
    PDF Downloaded183    
    Comments [Add]    
    Cited by others 1    

Recommend this journal