Question 1

What if sputum microscopy remains positive at the end of the intensive phase?

Accepted Answer

WHO recommends extending the intensive phase by 1 month and then reassessing. If still positive, evaluate for drug resistance (Xpert MTB/RIF, culture and DST) before proceeding to the continuation phase. Do not initiate the continuation phase with smear-positive sputum.

Question 2

How are missed doses calculated during directly observed therapy?

Accepted Answer

Each day without a scheduled dose under direct observation counts as a missed dose. Some programmes allow Saturday-only pickup for stable patients — this still counts as a dose only if the patient attends and ingests the medication. Weekend and holiday closures should be accounted for by pre-packaged doses.

Question 3

Does the tool support shorter regimens?

Accepted Answer

Yes — the tool accommodates the WHO-recommended 4-month (isoniazid and rifapentine) regimen for drug-susceptible TB in persons ≥12 years without extensive cavitation, and the shorter 9-month MDR-TB regimen for patients without fluoroquinolone resistance.