What Are the Elements of Tuberculosis Management?

It is a global tuberculosis control strategy recommended by the World Health Organization (WHO). The English full name is Directly Observed Treatment Short-course, abbreviated as DOTS. Therefore, the control strategy of modern tuberculosis is also referred to as DOTS strategy for short. Comprehensive supervision of chemotherapy for non-hospitalized tuberculosis patients can ensure regular medication and improve the cure rate.

Modern tuberculosis control strategies

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It is a global tuberculosis control strategy recommended by the World Health Organization (WHO). The English full name is Directly Observed Treatment Short-course, abbreviated as DOTS. Therefore, the control strategy of modern tuberculosis is also referred to as DOTS strategy for short. Comprehensive supervision of chemotherapy for non-hospitalized tuberculosis patients can ensure regular medication and improve the cure rate.

Actively discover and heal

The most effective way to control tuberculosis is to control it from its root cause. The source of tuberculosis transmission is the source of infection, especially tuberculosis patients with positive sputum smears. The transmission of tuberculosis is caused by the incurability of infectious tuberculosis patients. Once these patients are cured, the infection stops. The guiding ideology of modern tuberculosis control strategies is therefore to find and cure the source of infection. ^[2]

(1) Government's commitment: First, it should be clear that controlling tuberculosis is the responsibility of governments at all levels. The government should strengthen leadership and support for tuberculosis control, and provide sufficient funds to ensure the needs of modern tuberculosis control.

(2) Use sputum smear microscopy to detect patients with infectious tuberculosis.

(3) For smear-positive patients with infectious tuberculosis, treatment management under the supervision of the whole process, that is, each medication should be taken under the direct supervision of medical staff, and records should be taken to ensure that the patient regularly takes the medication until the completion of the treatment To achieve cure.

(4) Establish a continuous and uninterrupted supply of free anti-TB drugs. The state implements effective management of the production and supply of anti-tuberculosis drugs to ensure the quality of medicines and meet the needs of patient treatment.

(5) Establish a unified system for registration, reporting, monitoring and evaluation of TB patients. ^[3]

According to the WHO's 2008 Global TB Control Report, the number of TB cases in China in 2006 was 1.31 million, accounting for 14.3% of the world's total, ranking second in the world, and being one of 22 countries with a high burden of TB in the world. The results of the 2000 national tuberculosis epidemiological survey showed that the characteristics of the TB epidemic in China are: a large number of people infected, 550 million people in the country have been infected with tuberculosis, which is significantly higher than the global average infection level; there are many patients, and there are active patients with tuberculosis in the country About 4.5 million, of which about 1.5 million are infectious tuberculosis patients; there are many deaths, and about 130,000 people die from tuberculosis in the country; there are many rural patients, about 80% of tuberculosis patients in the country are in rural areas, and they are mainly concentrated in the central and western regions; drug resistance There are many patients, especially those with multidrug resistance and extensive drug resistance.

In China's infectious disease epidemic network report, the number of reported tuberculosis cases and deaths ranks at the forefront of Class A and B infectious diseases. Three-quarters of tuberculosis patients are the most capable young adults. Tuberculosis is still one of the major diseases that restrict the economic and social development of rural areas, especially poor areas. At the same time, China's tuberculosis prevention and treatment is also facing new challenges such as mobile population tuberculosis, multidrug-resistant tuberculosis and dual infection with tuberculosis / HIV. ^[4]

Global experience in implementing DOTS shows that DOTS is currently the most economical health strategy, and that DOTS is also the most effective weapon for preventing MDR-TB. At present, many countries and regions are slow to accept and implement the DOTS strategy, and the countries and regions that have accepted the DOTS strategy need to further expand their DOTS coverage. The World Health Organization proposes: "We are racing against time to enable the DOTS strategy to be implemented in more countries and regions before the spread of MDR-TB is more widespread." It can be said that the success of human struggle against tuberculosis will depend on the scope and speed of implementing the DOTS strategy. ^[5]