Abstract: Objective To determine the actual implementation s ituation and problem DOTS management of the smear positive pulmonary tuberculosi s cases.Methods To investigate the financial income and expenditure of four county dispensaries in 1996,1997.County,town and village doctors and 126 sm ear positive cases were investigated.Results The proportion of patients who were directly observed b y village doctor during all the course of treatment and intensive page of treat ment were 19.0%,74.6% respectively.The proportion of patients who didn’t miss dr ug was 95.2%.The number of patients treated by DOTS were 59.6% of the number of patients estimated by World Bank Loan Project.Conclusion The majority of patients were managed by village doc tors during intensive page of treatment and a few patients who missed drug.Few p atients who directly observed by village doctor during the whole course of treat ment.

Key words: Tuberculosis,pulmonary/prevention and control, DOTS