Your search found 85 Results
PLoS Medicine. 2017 Jun; 14(6):e1002328.Melanie Taylor and colleagues discuss global initiatives for surveillance of sexually transmitted diseases.
Management of childhood diarrhea by healthcare professionals in low income countries: An integrative review.
International Journal of Nursing Studies. 2017 Jan; 66:82-92.Background The significant drop in child mortality due to diarrhea has been primarily attributed to the use of oral rehydration solutions, continuous feeding and zinc supplementation. Nevertheless uptake of these interventions have been slow in developing countries and many children suffering from diarrhea are not receiving adequate care according to the World Health Organization recommended guidelines for the clinical management of childhood diarrhea. Objectives The aim of this integrative review is to appraise healthcare professionals’ management of childhood diarrhea in low-income countries. Design Whittemore and Knafl integrative review method was used, in conjunction with the Reporting of Observational Studies in Epidemiology (STROBE) checklist for reporting observational cohort, case control and cross sectional studies. Method A comprehensive search performed from December 2014 to April 2015 used five databases and focused on observational studies of healthcare professional's management of childhood diarrhea in low-income countries. Results A total of 21 studies were included in the review. Eight studies used a survey design while three used some type of simulated client survey referring to a fictitious case of a child with diarrhea. Retrospective chart reviews were used in one study. Only one study used direct observation of the healthcare professionals during practice and the remaining eight used a combination of research designs. Studies were completed in South East Asia (n = 13), Sub-Saharan Africa (n = 6) and South America (n = 2). Conclusion Studies report that healthcare providers have adequate knowledge of the etiology of diarrhea and the severe signs of dehydration associated with diarrhea. More importantly, regardless of geographical settings and year of study publication, inconsistencies were noted in healthcare professionals’ physical examination, prescription of oral rehydration solutions, antibiotics and other medications as well as education provided to the primary caregivers. Factors other than knowledge about diarrhea were shown to significantly influence prescriptive behaviors of healthcare professionals. This review demonstrates that “knowledge is not enough” to ensure the appropriate use of oral rehydration solutions, zinc and antibiotics by healthcare professionals in the management of childhood diarrhea.
Guideline: Managing possible serious bacterial infection in young infants when referral is not feasible.
Geneva, Switzerland, WHO, 2015.  p.This guideline, developed by a panel of international experts and informed by a thorough review of existing evidence, contains a number of recommendations on the use of antibiotics for neonates (0–28 days old) and young infants (0–59 days old) with PSBI in order to reduce young infant mortality rates. The guideline is intended for use in resource-limited settings in situations when families do not accept or cannot access referral care. The goal of the guideline is to provide clinical guidance on the simplest antibiotic regimens that are both safe and effective for outpatient treatment of clinical severe infections and fast breathing (pneumonia) in children 0–59 days old. In addition, the guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
WHO recommendations for prevention and treatment of maternal peripartum infections: Highlights and key messages from the World Health Organization's 2015 global recommendations.
[Geneva, Switzerland], WHO, 2015 Sep.  p. (WHO/RHR/15.19; WHO/MCA/15.01)Bacterial infections around the time of childbirth account for about one-tenth of maternal deaths and contribute to severe morbidity and long-term disability for many affected women. Standard infection prevention and control measures are a cornerstone of peripartum infection prevention (e.g., hand hygiene and use of clean equipment). WHO recommendations for prevention and treatment of maternal peripartum infections include both recommended and non-recommended interventions during labour, childbirth, and the postpartum period. Clinical monitoring, early detection, and prompt treatment of peripartum infection with an appropriate antibiotic regimen are essential for reducing death and morbidity in affected women. Recommendations for antibiotic prophylaxis / treatment for specific indications balance health benefits for the mother and newborn with safety concerns (e.g., adverse effects) and the public health imperative to control antibiotic resistance.
Geneva, Switzerland, WHO, 2015.  p. (WHO/RHR/15.21)This document consists largely of GRADE: Grading of Recommendations Assessment, Development and Evaluation tables for studies on maternal peripartum infection prevention and treatment practices.
Geneva, Switzerland, WHO, 2015.  p.The goal of the present guideline is to consolidate guidance for effective interventions that are needed to reduce the global burden of maternal infections and their complications around the time of childbirth. This forms part of WHO’s efforts to improve the quality of care for leading causes of maternal death, especially those clustered around the time of childbirth, in the post-MDG era. Specifically, it presents evidence-based recommendations on interventions for preventing and treating genital tract infections during labour, childbirth or the puerperium, with the aim of improving outcomes for both mothers and newborns.The primary audience for this guideline is health professionals who are responsible for developing national and local health protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women, including obstetricians, midwives, nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for both pre- and inservice training of health workers to enhance their delivery of care to prevent and treat maternal peripartum infections. (Excerpts)
Geneva, Switzerland, WHO, 2013.  p.This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, including in the context of HIV. The guideline will help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions for severely malnourished children. It will also support Member States in their efforts to achieve global targets on the maternal, infant and young child nutrition comprehensive implementation plan, especially global target 1, which entails achieving 40% reduction by 2025 of the global number of children under 5 years who are stunted and global target 6 that aims to reduce and maintain childhood wasting to less than 5%. The guideline is intended for a wide audience, including policy-makers, their expert advisers, and technical and programme staff in organizations involved in the design, implementation and scaling-up of nutrition actions for public health. The guideline will form the basis for a revised manual on the management of severe malnutrition for physicians and other senior health workers, and a training course on the management of severe malnutrition..
Time for new recommendations on cotrimoxazole prophylaxis for HIV-exposed infants in developing countries?
Bulletin of the World Health Organization. 2010 Dec 1; 88(12):949-50.Add to my documents.
Geneva, Switzerland, WHO, 2012. 41 p.Postpartum haemorrhage (PPH) is a major cause of mortality, morbidity and long term disability related to pregnancy and childbirth. Effective interventions to prevent and treat PPH exist and can largely reduce the burden of this life-threatening condition. Given the availability of new scientific evidence related to the prevention and treatment of PPH, this document updates previous WHO recommendations and adds new recommendations for the prevention and treatment of PPH. The primary goal of this guideline is to provide a foundation for the implementation of interventions shown to have been effective in reducing the burden of PPH. Health professionals responsible for developing national and local health policies constitute the main target audience of this document. Obstetricians, midwives, general medical practitioners, health care managers and public health policy-makers, particularly in under-resourced settings are also targeted. This document establishes general principles of PPH care and it is intended to inform the development of clinical protocols and health policies related to PPH.
Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics.
Bulletin of the World Health Organization. 2011 Aug 1; 89(8):594-607.OBJECTIVE: To systemically review the evidence in support of World Health Organization guidelines recommending broad-spectrum antibiotics for children with severe acute malnutrition (SAM). METHODS: CENTRAL, MEDLINE, EMBASE, LILACS, POPLINE, CAB Abstracts and ongoing trials registers were searched. Experts were contacted. Conference proceedings and reference lists were manually searched. All study types, except single case reports, were included. FINDINGS: Two randomized controlled trials (RCTs), one before-and-after study and two retrospective reports on clinical efficacy and safety were retrieved, together with 18 pharmacokinetic studies. Trial quality was generally poor and results could not be pooled due to heterogeneity. Oral amoxicillin for 5 days was as effective as intramuscular ceftriaxone for 2 days (1 RCT). For uncomplicated SAM, amoxicillin showed no benefit over placebo (1 retrospective study). The introduction of a standardized regimen using ampicillin and gentamicin significantly reduced mortality in hospitalized children (odds ratio, OR: 4.0; 95% confidence interval, CI: 1.7-9.8; 1 before-and-after study). Oral chloramphenicol was as effective as trimethoprim-sulfamethoxazole in children with pneumonia (1 RCT). Pharmacokinetic data suggest that normal doses of penicillins, cotrimoxazole and gentamicin are safe in malnourished children, while the dose or frequency of chloramphenicol requires adjustment. Existing evidence is not strong enough to further clarify recommendations for antibiotic treatment in children with SAM. CONCLUSION: Large RCTs are needed to define optimal antibiotic treatment in children with SAM with and without complications. Further research into gentamicin and chloramphenicol toxicity and into the pharmacokinetics of ceftriaxone and ciprofloxacin is also required.
Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian regions, 2007-2008.
Communicable Diseases Intelligence. 2010 Mar; 34(1):1-7.Long-term surveillance of antimicrobial resistance in Neisseria gonorrhoeae has been conducted in the World Health Organization (WHO) Western Pacific Region (WPR) to optimise antibiotic treatment of gonococcal disease since 1992. In 2007 and 2008, this Gonococcal Antimicrobial Surveillance Programme (GASP) was enhanced by the inclusion of data from the South East Asian Region (SEAR) and recruitment of additional centres within the WPR. Approximately 17,450 N. gonorrhoeae were examined for their susceptibility to one or more antibiotics used for the treatment of gonorrhoea by external quality controlled methods in 24 reporting centres in 20 countries and/or jurisdictions. A high proportion of penicillin and/or quinolone resistance was again detected amongst isolates tested in North Asia and the WHO SEAR, but much lower rates of penicillin resistance and little quinolone resistance was present in most of the Pacific Island countries. The proportion of gonococci reported as 'resistant', 'less susceptible' or 'non-susceptible' gonococci to the third-generation cephalosporin antibiotic ceftriaxone lay in a wide range, but no major changes were evident in cephalosporin minimal inhibitory concentration (MIC) patterns in 2007-2008. Altered cephalosporin susceptibility was associated with treatment failures following therapy with oral third-generation cephalosporins. There is a need for revision and clarification of some of the in vitro criteria that are currently used to categorise the clinical importance of gonococci with different ceftriaxone and oral cephalosporin MIC levels. The number of instances of spectinomycin resistance remained low. A high proportion of strains tested continued to exhibit a form of plasmid mediated high level resistance to tetracyclines. The continuing emergence and spread of antibiotic resistant gonococci in and from the WHO WPR and SEAR supports the need for gonococcal antimicrobial resistance surveillance programs such as GASP to be maintained and potentially expanded.
Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response.
Geneva, Switzerland, WHO, 2010.  p.This new report on anti-tuberculosis (TB) drug resistance by the World Health Organization (WHO) updates "Anti-tuberculosis drug resistance in the world: Report No. 4" published by WHO in 2008. It summarizes the latest data and provides latest estimates of the global epidemic of multidrug and extensively drug-resistant tuberculosis (M/XDR-TB). For the first time, this report includes an assessment of the progress countries are making to diagnose and treat MDR-TB cases. (Excerpt)
Tuberculosis retreatment category predicts resistance in hospitalized retreatment patients in a high HIV prevalence area.
International Journal of Tuberculosis and Lung Disease. 2009 Oct; 13(10):1274-80.SETTING: Rates of multidrug-resistant tuberculosis (MDR-TB) are currently as high as 7.7% in retreatment cases in KwaZulu-Natal, South Africa. MDR-TB prevalence is known to be high in patients categorized as treatment failures. Recent reports have questioned the effectiveness of the World Health Organization (WHO) Category II regimen in retreatment TB cases. OBJECTIVE: To determine whether treatment category predicts susceptibility patterns and outcomes in a hospitalized population of retreatment TB cases. DESIGN: Retrospective cohort of 197 pulmonary retreatment cases. RESULTS: Retreatment cases treated with the standard retreatment regimen had a high in-hospital mortality (19.8%), or poor outcome (26.4%) and a high rate of MDR-TB (16.2%). The 'treatment failure' category predicted resistance, with 57.1% of patients exhibiting any resistance compared to other treatment categories (P = 0.02); 53.8% of patients with any resistance experienced poor outcomes, compared to 16.6% of pan-susceptible cases (P = 0.02). There was a trend towards poor outcome in the treatment failure category (42.9%, P = 0.13). CONCLUSION: The retreatment category 'treatment failure' is associated with a high prevalence of resistance in an area of high human immunodeficiency virus (HIV) prevalence. The 'treatment failure' category should be used to identify patients who may benefit from alternative regimens using directed, intensified therapy or second-line agents instead of the current standard retreatment regimen.
Bulletin of the World Health Organization. 2008 Sep; 86(9):658.The incidence and prevalence of tuberculosis (TB) in children are increasing and becoming a particular problem in countries that are also affected by the HIV epidemic.1 Tuberculosis in children has been seen as hard to diagnose but, at least in developed countries, relatively easy to treat. However, in children with HIV, severe disease is more frequent and this has led to a reexamination of treatment regimens. (excerpt)
[WHO updates medical eligibility criteria for contraceptives] OMS reactualizeaza criteriile medicale de eligibilitate pentru utilizarea contraceptivelor.
Targu-Mures, Romania, Institutul Est European de Sanatate a Reproducerii, 2006. 15 p. (Actualitati in planificarea familiala No. 1)The World Health Organization (WHO) has issued new family planning guidance, including the following: Most women with HIV infection generally can use IUDs. Women generally can take hormonal contraceptives while on antiretroviral (ARV) therapy for HIV infection, although there are interactions between contraceptive hormones and certain ARV drugs. Women with clinical depression usually can take hormonal contraceptives. More than 35 experts met at WHO headquarters in Geneva, Switzerland, in October 2003 and developed this and other new guidance. The new guidance updates the 2000 Medical Eligibility Criteria (MEC) for Contraceptive Use. (excerpt)
Pakistan Journal of Medical Sciences. 2007 Oct-Dec; 23(6):932-935.The objectives were to compare the prevailing prescribing practices of paediatricians with minor and major diploma for common paediatric problems. It was a Cross sectional study in which 10 % of children visiting the outpatient department of paediatrics, Hamdard university hospital with gastroenteritis and Acute respiratory infections, diagnosed according to UNICEF/ WHO protocol were enrolled, their prescriptions checked and results were entered in specially designed Performa. Five hundred prescriptions were reviewed of which 308 were due to Gastro enteritis, 192 were due to respiratory tract infections1). Average numbers of drugs/ prescription were 3.33 +or- 1.2. Paediatricians with minor diploma prescribed 3.5 +or- 1.2 drugs/ prescription. Paediatricians with major diploma prescribed 2.8 +or-1.2 drugs/ prescription (p-valve 0.32) Antibiotic in diarrhoea and respiratory tract infections (upper and lower respiratory tract infections were written in 81.7% cases by paediatricians with lower diploma and 77.7 % cases by paediatricians with major diploma (p-valve 0.27). In respiratory tract infections antihistamines were prescribed in 79.7% of cases by paediatricians with minor diploma and 69.5 % cases by paediatricians with major diploma (p-valve0.11). Anti emetic in Gastroenteritis were written in 69.1% cases by paediatricians with minor diploma and 56.2% cases by Paediatricians with major diploma (p-valve 0.021). More drugs and more antibiotic were given by doctors, with major diploma. Antibiotics were totally different than recommended by the National ARI programme, which the Paediatricians teach in Medical Colleges. The antibiotics prescribed for common Paediatric Problems were totally different than recommended by the National ARI programme which the Paediatricians teach in Medical College. Active intervention is needed to improve the quality of medical education of physicians who treat children, while in depth measures are required for the training of paediatricians. (author's)
Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: A randomised equivalency trial.
Lancet. 2008 Jan 5; 371(9606):49-56.WHO case management guidelines for severe pneumonia involve referral to hospital for treatment with parenteral antibiotics. If equally as effective as parenteral treatment, home-based oral antibiotic treatment could reduce referral, admission, and treatment costs. Our aim was to determine whether home treatment with high-dose oral amoxicillin and inpatient treatment with parenteral ampicillin were equivalent for the treatment of severe pneumonia in children. This randomised, open-label equivalency trial was done at seven study sites in Pakistan. 2037 children aged 3-59 months with severe pneumonia were randomly allocated to either initial hospitalisation and parenteral ampicillin (100 mg/kg per day in four doses) for 48 h, followed by 3 days of oral amoxicillin (80-90 mg/kg per day; n=1012) or to home-based treatment for 5 days with oral amoxicillin (80-90 mg/kg per day in two doses; n=1025). Follow-up assessments were done at 1, 3, 6, and 14 days after enrolment. The primary outcome was treatmentfailure (clinical deterioration) by day 6. Analyses were done per protocol and by intention to treat. This trial is registered, ISRCTN95821329. In the per-protocol population, 36 individuals were excluded from the hospitalised group and 37 from the ambulatory group, mainly because of protocol violations or loss to follow-up. There were 87 (8.6%) treatment failures in the hospitalised group and 77 (7.5%) in the ambulatory group (risk difference 1.1%; 95% CI -1.3 to 3.5) by day 6. Five (0.2%) children died within 14 days of enrolment, one in the ambulatory group and four in the hospitalised group. In each case, treatment failure was declared before death and the antibiotic had been changed. None of the deaths were considered to be associated with treatment allocation; there were no serious adverse events reported in the trial. Home treatment with high-dose oral amoxicillin is equivalent to currently recommended hospitalisation and parenteral ampicillin for treatment of severe pneumonia without underlying complications, suggesting that WHO recommendations for treatment of severe pneumonia need to be revised. (author's)
Washington, D.C., World Bank, Human Development Network, Health, Nutrition and Population Team, 2007 Aug. 51 p. (Policy Research Working Paper No. 4295)Tuberculosis is the most important infectious cause of adult deaths after HIV/AIDS in low- and middle-income countries. This paper evaluates the economic benefits of extending the World Health Organization's DOTS Strategy (a multi-component approach that includes directly observed treatment, short course chemotherapy and several other components) as proposed in the Global Plan to Stop TB, 2006-2015. The authors use a model-based approach that combines epidemiological projections of averted mortality and economic benefits measured using value of statistical life for the Sub-Saharan Africa region and the 22 high-burden, tuberculosis-endemic countries in the world. The analysis finds that the economic benefits between 2006 and 2015 of sustaining DOTS at current levels relative to having no DOTS coverage are significantly greater than the costs in the 22 high-burden, tuberculosis-endemic countries and the Africa region. The marginal benefits of implementing the Global Plan to Stop TB relative to a no-DOTS scenario exceed the marginal costs by a factor of 15 in the 22 high-burden endemic countries, a factor of 9 (95% CI, 8-9) in the Africa region, and a factor of 9 (95% CI, 9-10) in the nine high-burden African countries. Uncertainty analysis shows that benefit-cost ratios of the Global Plan strategy relative to sustained DOTS were unambiguously greater than one in all nine high-burden countries in Africa and in Afghanistan, Pakistan, and Russia. Although HIV curtails the effect of the tuberculosis programs by lowering the life expectancy of those receiving treatment, the benefits of the Global Plan are greatest in African countries with high levels of HIV. (author's)
Lancet. 2007 Aug; 370(9585):386-387.The important study by Lisa McNally and colleagues challenges the validity of the WHO recommendations for empirical antibiotic treatment of HIV-infected children with pneumonia. It is, however, important to recognise the limited options for improving these recommendations, given the complexity of the causes of pneumonia among children for whom treatment fails. In particular, changes of antibiotic regimen alone would be unlikely to improve treatment failure in children infected with respiratory viruses (33%). Some of the pneumonias caused by both pneumococci and respiratory viruses might, however, be preventable by vaccination with pneumococcal conjugate vaccines. Additionally, the identification of Pneumocystis jirovecii as the most significant pathogen in infants with treatment failure, despite empirical treatment as recommended by WHO, confirms the limited success of treating HIV-infected children with severe P jirovecii pneumonia. The higher prevalence (15%) of Mycobacterium tuberculosis in this study than in three other studies (8% each), might be related to a greater sensitivity of methods used for sample collection and an increasing burden of tuberculosis. Nevertheless, the observation that M tuberculosis was identified in 21.8% of children with treatment failure perhaps merits most attention. Of particular noteworthiness is that all the studies focused on children with an acute illness, challenging the numerous clinical algorithms used for making a clinical diagnosis of pulmonary tuberculosis and the notion that this disorder rarely presents acutely. The management of childhood pulmonary tuberculosis deserves greater priority and is the one issue that can and should be addressed more urgently. We believe tuberculosis should be included in both diagnostic and therapeutic algorithms for acute childhood pneumonia in areas with high HIV and tuberculosis prevalence. (full text)
Bulletin of the World Health Organization. 2007 Aug; 85(8):631-636.Following the destruction of Cambodia's health infrastructure during the Khmer Rouge period (1975-1979) and the subsequent decade of United Nations sanctions, international development assistance has focused on reconstructing the country's health system. The recognition of Cambodia's heavy burden of tuberculosis (TB) and the lapse of TB control strategies during the transition to democracy prompted the national tuberculosis programme's relaunch in the mid-1990s as WHO-backed health sector reforms were introduced. This paper examines the conflicts that arose between health reforms and TB control programmes due to their different operating paradigms. It also discusses how these tensions were resolved during introduction of the DOTS strategy for TB treatment. (author's)
Evidence behind the WHO Guidelines: Hospital care for children: What is the appropriate empiric antibiotic therapy in uncomplicated urinary tract infections in children in developing countries?
Journal of Tropical Pediatrics. 2007 Jun; 53(3):150-152.Urinary tract infection (UTI) is an important cause of morbidity and mortality in children. Studies from developing countries show that the around 10% of children with febrile illnesses have UTI . Studies have shown a higher UTI prevalence of 8-35% in malnourished children. The risk of developing UTI before the age of 14 is ~1% in boys and 3-5% in girls. Due to lack of overt clinical features in children less than 2 years, appropriate collection of urine samples and basic diagnostic tests at first-level health facilities in developing countries, UTI are not generally reported as a cause of childhood mortality. If poorly treated or undiagnosed, UTI is an important cause of long-term morbidities such as hypertension, failure to thrive and end-stage renal disease. Unfortunately, many of the organisms responsible for UTI in developing and industrialized countries have become resistant to first-line antimicrobials. It is thus necessary to establish the type of pathogen and antimicrobial sensitivities in the local environment in order to treat the UTI with the appropriate antibiotic. (excerpt)
[Diagnosis and treatment of tuberculosis in children -- an updated review of an old problem] Diagnostico e terapeutica da tuberculose infantil -- uma visao atualizada de um antigo problema.
Jornal de Pediatria. 2002 Nov-Dec; 78 Suppl 2:S205-S214.Tuberculosis is still one of the most severe chronic diseases, especially in the world's poorest regions. Developing countries still have to face serious problems related to this endemic disease, in spite of the control programs they have implemented. The present study aims at updating the diagnosis and treatment of tuberculosis in three South American countries: Brazil, Chile and Argentina. Sources: Medline and Lilacs databases, official guidelines and consensuses of the three countries involved. Brazil, Chile and Argentina have guidelines based on the World Health Organization documents and on international consensuses. The standardization is similar between these countries, allowing the unification of language and favoring control measures. Within the Brazilian context, the new guidelines on the treatment of tuberculosis set out by the Ministry of Health are presented. Since each country had to make adaptations in an attempt to solve the epidemiological differences between them, the treatments against tuberculosis still present some discrepancies, such as the use of three or four drugs in some cases. (author's)
Geneva, Switzerland, World Health Organization [WHO], 2006 Apr. 20 p. (WHO/HTM/TB/2003.328 Rev.2)The IDA Foundation is a non-profit organization supporting health care in low- and middle-income countries by providing high-quality drugs and medical supplies at the lowest possible price. In addition, IDA provides procurement agency services and offers consultancy and training on topics related to the various aspects of pharmaceutical supply management. IDA is based in the Netherlands and is ISO 9002-2000 and GDP certified. The quality of IDA products is verified in IDA's GcLP-approved laboratories. GLC is a subgroup of the Stop TB Working Group on DOTS-Plus for MDR-TB. GLC has been established to review applications from potential DOTS-Plus pilot projects and determine whether they are in compliance with WHO's Guidelines for establishing DOTSPlus pilot projects for the management of MDR-TB. Projects that are approved will benefit from second-line anti-TB drugs at concessional prices and from technical assistance from the GLC. (excerpt)
Engaging all health care providers in TB control. Guidance on implementing public-private mix approaches.
Geneva, Switzerland, World Health Organization [WHO], Stop TB Department, 2006. 52 p. (WHO/HTM/TB/2006.360)A great deal of progress has been made in global tuberculosis control in recent years through the large-scale implementation of DOTS. It has been acknowledged though that TB control efforts worldwide, although impressive, are not sufficient. The global TB targets -- detecting 70% of TB cases and successfully treating 85% of them, and halving the prevalence and mortality of the disease by 2015 as part of the Millennium Development Goals (MDGs) -- are likely to be met only if current efforts are intensified. Among the important interventions required to reach these goals would be a systematic involvement of all relevant health care providers in delivering effective TB services to all segments of the population. Therefore, engaging all health care providers in TB control is an essential component of WHO's new Stop TB strategy¹ and the Stop TB Partnership's Global Plan to Stop TB 2006-2015. (excerpt)
The Stop TB Strategy: building on and enhancing DOTS to meet the TB-related Millennium Development Goals.
Geneva, Switzerland, World Health Organization [WHO], 2006. 22 p. (WHO/HTM/STB/2006.37)Since the development of the DOTS strategy, WHO and partners have worked on complementary policies and strategies to address the remaining major constraints to achievement of global TB control targets. These include expanding access to diagnosis and treatment through community TB care, and public--private mix (PPM) approaches aimed at engaging all care providers -- state and non-state -- in DOTS implementation. Innovative mechanisms such as the Global Drug Facility and the Green Light Committee have been developed to improve access to quality-assured and affordable drugs in resource-poor settings. The collaborative activities that need to be implemented by TB and HIV/AIDS control programmes have been defined, and strategies for managing multidrug-resistant TB (MDR-TB) have been developed and tested. Impact assessment is being pursued as a means of evaluating progress towards the MDGs. New partnerships and academic research initiatives for development of new tools are beginning to produce results and several new diagnostics, drugs and candidate vaccines are in the pipeline. (excerpt)