Principles of IUATLD collaborative tuberculosis progammes.
The success of IUATLD-assisted National Tuberculosis Programme developed by Dr. Karel Styblo is dependent on a number of important principles. The most important step is the organization of the basic components of the National Tuberculosis Programme. This first step requires 1) a political commitment on the part of the Government, 2) a secure supply of drugs and materials, including a reserve stock, 3) a network of microscopy centres with a system of quality control and 4) proper recording and reporting of cases. These conditions can result in significant improvement in case-finding and treatment results but rarely results in a cure rate of smear-positive cases in excess of 55 per cent. To obtain the levels of cure necessary to achieve an epidemiologic impact, it is necessary to employ short-course chemotherapy. Additional conditions must be met for this to be successful: 1) adequate supervision of drug-taking in the initial intensive phase, 2) proper training of staff prior to commencement of the treatment and 3) step-wise introduction throughout the country. Several factors may adversely affect the outcome of treatment programmes. These are drug resistance, a high rate of relapse and HIV infection. To date, the IUATLD-assisted programmes have shown sustained success.
Enarson
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DA
University of Alberta, Department of Medicine, Edmonton, Canada.
D006801:Humans; D007390:International Agencies / Q000458:organization & administration*; D007391:International Cooperation; D009313:National Health Programs / Q000458:organization & administration* / Q000592:standards; D009937:Organizational Objectives; D011785:Quality Assurance, Health Care; D015996:Survival Rate; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*