PakMediNet Discussion Forum : Public Health : Tuberculosis
the biggest public health problem of hte developing countries. still out of control. due to many reasons. the most important is that according to a study one out of seven doctor know exact tratment of TB.
Posted by: chughtaiPosts: 22 :: 30-07-2004 :: | Reply to this Message
Very unfortunate.
I think Govt esp. PMDC should play active role in refreshers courses for different doctors of remote places. This would definitely help in controlling TB. However, I have seen even doctors of Govt TB hospitals, lack complete knowledge regarding TB. Really very unfortunate.
Posted by: yasirPosts: 90 :: 30-07-2004 :: | Reply to this Message
yes u r right.
i also belong to a TB center. now Govt is very much active but unfortunately Drs did not want to learn. our 70% patient goes to private practitionerws and they are least interested in new WHO strategy of TB control i.e. DOTS. i would like to take the feedback of dear colleagues about the DOTS. kindly tell me about the DOTS, wt u know about it.
quote:
yasir wrote:
Very unfortunate.
I think Govt esp. PMDC should play active role in refreshers courses for different doctors of remote places. This would definitely help in controlling TB. However, I have seen even doctors of Govt TB hospitals, lack complete knowledge regarding TB. Really very unfortunate.
Posted by: chughtaiPosts: 22 :: 04-08-2004 :: | Reply to this Message
The internationally-recommended TB control strategy is DOTS. DOTS combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems, and use of highly efficacious regimes with direct observation of treatment.
Once patients with infectious TB (bacilli visible in a sputum smear) have been identified using microscopy services, health and community workers and trained volunteers observe and record patients swallowing the full course of the correct dosage of anti-TB medicines (treatment lasts six to eight months). The most common anti-TB drugs are isoniazid, rifampicin, pyrazinamide, streptomycin and ethambutol.
Sputum smear testing is repeated after two months, to check progress, and again at the end of treatment. A recording and reporting system documents patients' progress throughout, and the final outcome of treatment.
Posted by: chughtaiPosts: 22 :: 05-08-2004 :: | Reply to this Message
DOTS expension
Although during the past decade DOTS - the strategy promoted by WHO to control tuberculosis (TB) - has been widely accepted, many developing countries have been unable to expand coverage as rapidly as needed and have failed to achieve the global targets of detecting 70% of infectious cases and curing 85% of those detected by the year 2000.1 Progress has been slow. In 2001, only 43% of infectious cases were detected and treated under the DOTS strategy.
In March 2000, the Amsterdam Declaration to Stop TB called for increased political commitment and financial resources to reach the targets for global TB control by 2005.2 In May 2000, a World Health Assembly (WHA) resolution restated this call.3
In response to both the Amsterdam Declaration and the WHA resolution, National Tuberculosis Programme (NTP) managers of the 22 high-burden countries, technical partners, financial partners, and the global TB network of WHO agreed to develop a Global DOTS Expansion Plan (GDEP) at the first DOTS Expansion Working Group meeting in Cairo in November 2000.
The two pillars of the GDEP are the development of national DOTS expansion plans and partnership-building to control tuberculosis.
DOTS expansion plans for the medium-term must be technically sound and feasible for implementation, and take into account the characteristics of the national health system. This plan should identify the major inputs and associated budget required for DOTS expansion.
In 2002, 20 out of 22 high-burden countries had a medium-term DOTS expansion plan. Another high burden country is currently developing one.
Partnership is crucial for success in controlling tuberculosis. Partnerships must be built among countries, agencies, foundations, and nongovernmental organizations (NGOs), respecting and reinforcing the sovereignty of countries for the health of their people.
Posted by: chughtaiPosts: 22 :: 11-08-2004 :: | Reply to this Message
Dr. Abdul Majid (Chief Resident, Community Medicine, Aga Khan University - Email: abdul.majid(CHS)) has done lot of work in this field. He recently conducted a study on Quality of TB care in public and private sector in district Thatta. If you want to know more and collaborate on this effort, please contact him.
Regards,
Dr. Zafar Fatmi
Email: zafar.fatmi@aku.edu
Posted by: fatmizPosts: 3 :: 04-12-2004 :: | Reply to this Message