Bring TB patients under DOTS
Tareq Salahuddin
Tuberculosis (TB) is a major public health problem in Bangladesh. The country ranks 5th on the list of 22 highest burden TB countries in the world. It is estimated that 300,000 new cases crop up each year, of which about half of them are infectious TB. It is further estimated that about 70,000 people die every year.Hence, each hour eight persons die of the disease for which very effective treatment (DOT), free of cost, is available in Bangladesh. Before 1993 TB control was limited to TB clinics and TB hospitals. Field implementation of TB control integrated into the general health services, delivered by Upazila Health Complexes (UHC's), started back in 80s. However, NTP Bangladesh revised its strategies and adopted DOTS in 1993. NGO's have been involved since 1994. Facts about TB - Tuberculosis is a disease caused by bacteria.
- There are two types of TB according to the location of infection – 1. Pulmonary TB or lungs TB, 2. Extra-pulmonary TB or TB that affect any part of the body other than lung.
- Pulmonary TB is the infectious one that occurs in about 80 percent cases.
- Transmission of pulmonary TB occurs by spreading of the bacteria into the air mainly through coughing, spitting, sneezing by a patient.
Key symptom of pulmonary TB
Cough for three weeks or more associated with fever, lethargy, loss of appetite and weight loss. What is DOTS?
The internationally recommended approach for TB treatment is Directly Observed Treatment Short-course (DOTS). It is an inexpensive strategy that could prevent millions of TB cases and deaths over the coming decade. Under this strategy, if a patient with infectious TB has been identified using microscopy services, health and community workers or trained volunteers observed the patient shallowing the full course of correct dosage of anti-TB medicine. Advantages of DOTS - The DOTS can produce cure rates up to 95 percent
- It can prevent new infections by curing infectious patients
- It prevents development of multi drug resistance by ensuring that the full course of treatment is followed
DOTS in Bangladesh
Bangladesh adopted the DOTS in 1993 to combat TB. But it is a matter of great regret that the referral system is not yet satisfactory. It is important that all patients should be brought under DOTS rather than treatment under particular care or responsibility. The National TB control Programme (NTP) ensures DOTS through the government healthcare facilities and some NGOs. The health assistants and sasthwa sebika (female health worker) ensures DOTS all over the country. The drug is totally free of cost. NGO activities
There are different partners to implement the NTP in different parts of Bangladesh. People should seek the TB treatment in those organisations. For example, in urban and periurban areas of the divisional headquarters are served by BRAC. There is a dire need for the control of TB in Bangladesh, otherwise we will face an epidemiological crisis.
| 
