DIANA SEPTIYANTI DOTS Directly Observed Treatment Shortcourse The most effective strategy available for controlling the TB epidemic today INTRODUCTION Introduction 2 5 ID: 920449
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Slide1
TB – DOTS(Direct Observed Therapy, Short Course)
DIANA SEPTIYANTI
Slide2DOTS…....
Directly
Observed Treatment,
Short-course
The
most
effective strategy available for controlling the TB epidemic today
INTRODUCTION
Slide3Introduction (2)
5
Slide4The TB Epidemic
TB is
A
contagious
bacterial disease caused by
Mycobacterium tuberculosis
Transmitted
by the
inhalation
route as droplet infection
Slide590%
10%
Slide6WHO
Global TB Report 2016. WHO, 2016
BURDEN OF TUBERCULOSIS
Incidence
395/100.000
Mortality
rate
40/100.000
Case Detection Rate
33
%
Succses Rate
84
%
Slide7BURDEN OF TB (2)
Incidence TB-RO: 32.000
Confirmed TB-RO:
2.135
TB-RO had started treatment:
1.519
SR TB-RO treatment:
51%
WHO
Global TB Report 2016. WHO, 2016
Slide8BURDEN OF TB (3)
WHO
Global TB Report 2016. WHO, 2016
Slide9TB in the Developing World
High burden of TB ….....
TB control
priority
public health Implementation of the DOTS strategy can
accelerate the decline
in the
annual rate
of TB infections
P
rimary healthcare
network
Slide10THE DEVELOPMENT OF DOTS
Slide11THE DEVELOPMENT OF DOTS (2)
Long-course Drug Treatment
Before anti-TB era
strengthen a patient’s resistance to
TB
rest the diseased part of the lung
Before anti-TB era
Drug developed
Dramatic reduction of case fatality
Slide12THE DEVELOPMENT OF DOTS (3)
Short-course
Drug Treatment
Rifampicin
1970
6-8 months
Slide13THE DEVELOPMENT OF DOTS (4)
The
Styblo
/
IUATLD
Model of TB Control
1970s
Dr
Karel
Styblo
-IUATLD
model of TB control
The Tanzania National TB Control
Programme
SUCCESS
U
sing
staff
and
resources necessary to
diagnose
, initiate treatment, record
and report
patient treatment progress, and manage supplies in
100,000 to 150,000 population area
Slide14THE DEVELOPMENT OF DOTS (5)
WHO and
The DOTS
Strategy
1993
Global Tuberculosis
Programme
DOTS
10
1990
102
1997
<1% cases
1990
16% cases
1997
Slide15Slide16Slide17Slide18Slide19Slide20Slide21Implementing DOTS
Pilot
project phase
Expansion
phase
Maintenance
phase
Careful
planning
few demonstration and training
districts
the training sites for staff from other districts in the same region
Slide22Implementing DOTS
Expansion
phase
Emphasis
on training, monitoring and
supervision
The
regional
demonstration and
training districts then serve as training sites for staff throughout the
same region
Slide23Expansion
phase
Implementing
DOTS
Maintain effective performance
over
time
Commitment and funding in
TB control.
Slide24The Future of TB Control
More funds must be allocated to TB control
Health
sector reform should enhance, not jeopardize, TB
control services
Health
workers, especially in low-income countries, must be trained and compensated appropriately to ensure a motivated workforceGovernments must take ownership of TB as a national problem
rather than
relying solely on international agencies to combat the
disease
Physicians
must support the implementation of DOTS and be a
full partner
in TB control
efforts
Countries must not tolerate TB as an
inevitability
Slide25Conclusion
DOTS has five key components:Government commitment to sustained TB control activities.
Case
detection by sputum smear microscopy among symptomatic
patients self-reporting
to health
services.Standardized treatment regimen of six to eight months for at least all confirmed sputum smear positive cases, with directly observed treatment for at least the initial two months.A
regular, uninterrupted supply of all essential anti-TB
drugs.
A
standardized recording and reporting system that allows assessment
of treatment
results for each patient and of the TB control
programme
overall
.
Slide26THANK YOU