irectly observed treatment (DOT) has been the standard of care for tuberculosis since the early 1990s.It arose from early observations that irregular treatment could threaten clinical outcomes and public health through generation of drug resistance, relapse, and transmission of infection. DOT is currently recommended by WHO and the American Thoracic Society. In England (UK) it is advised for patients at high risk of poor adherence, including those with clinically complex disease, multidrug-resistant (MDR) tuberculosis, mental health problems, previous tuberculosis treatment, or poor adherence. DOT is also advised for socially complex groups (eg, people with history of homelessness, imprisonment, or drug use or alcohol problems).