To the Editors:
In a recent issue of the European Respiratory Journal, Yew et al. [1] recalled the change from DOTS (directly observed treatment, short course) strategy to a more comprehensive approach, the Stop TB Strategy, adopted by the World Health Organization. Three of the six components of this strategy are the pursuit of high-quality DOTS expansion and enhancement, the engagement of all care providers, and the empowerment of people with tuberculosis and communities through partnership. We present a project based on the decentralisation of treatment and on patient participation in the choice of DOT supporter, in line with the Stop TB Strategy as presented by Yew et al. [1]. In Portugal, DOT is mandatory, and is performed principally in an outpatient setting within Pulmonary Health Centers (CDPs); these are primary care units dedicated to the diagnosis, treatment and surveillance of tuberculosis. Tuberculosis patients continue to suffer from social stigma and find it embarrassing to be subjected to DOT in CDP facilities. To deal with this problem, the Vila Nova de Gaia CDP team and the National Association of Pharmacies (ANF) designed and implemented a …