OBJECTIVE To assess the cost and cost-effectiveness of the Public-Private Mix DOTS (PPM-DOTS) strategy for tuberculosis (TB) control in India. METHODS We collected data on the costs and effects of pilot PPM-DOTS projects in Delhi and Hyderabad using documentary data and interviews. The cost of PPM-DOTS was compared with public sector DOTS (i.e. DOTS delivered through public sector facilities ...

Firstly, in 2006, the new Stop TB Strategy was launched by the World Health Organization (WHO), following intensive exploration and discussion with TB control programme managers in high burden countries and partner organisations, including technical agencies and donors [2]. The DOTS strategy (consisting of five key elements: government commitment, diagnosis through microscopy, standardised and ...

The World Health Organization (WHO)-recommended strategy of tuberculosis (TB) control has evolved from the DOTS (directly observed treatment, short course) strategy to the Stop TB strategy [1, 2]. By breaking the chain of transmission through rapid diagnosis and effective treatment of infectious TB cases, this strategy allowed the development of national TB programmes and proved to be highly co...

OBJECTIVE To assess whether the global target of halving tuberculosis (TB) mortality between 1990 and 2015 can be achieved and to conduct the first global assessment of the lives saved by the DOTS/Stop TB Strategy of the World Health Organization (WHO). METHODS Mortality from TB since 1990 was estimated for 213 countries using established methods endorsed by WHO. Mortality trends were estimat...

This article aims to present the current situation of tuberculosis and how the DOTS (Directly Observed Treatment Short Course) strategy has impacted national tuberculosis control programs worldwide, in Latin America and in Brazil. Data reveal a tendency towards a slow decline in disease rates (1%) around the world in 2003. In Brazil, data indicate a constant downward tendency of approximately 3...

OBJECTIVE To describe the implantation and the effects of directly-observed treatment short course (DOTS) in primary health care units. METHODS Interviews were held with the staff of nine municipal health care units (MHU) that provided DOTS in Rio de Janeiro City, Southeastern Brazil, in 2004-2005. A dataset with records of all tuberculosis treatments beginning in 2004 in all municipal health...

BACKGROUND Tuberculosis is curable, but community surveys documenting epidemiological impact of the WHO-recommended DOTS strategy on tuberculosis prevalence have not been published. We used active community surveillance to compare the impact of DOTS with earlier programmes. METHODS We conducted tuberculosis disease surveys using random cluster sampling of a rural population in South India app...

OBJECTIVE This study sought to determine the impact of the World Health Organization's directly observed treatment strategy (DOTS) compared with that of DOTS-plus on tuberculosis deaths, mainly in the developing world. DESIGN Decision analysis with Monte Carlo simulation of a Markov decision tree. DATA SOURCES People with smear positive pulmonary tuberculosis. DATA ANALYSIS Analyses model...

OBJECTIVE To define TB control priorities using cost-effectiveness and burden of disease. METHODS An assumed cohort of 2,000 cases was set up based on age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivity with natural history and DOTS intervention were constructed based on the epidemiological parameters. RE...

For 10 years the World Health Organisation has had a single answer to the deadly threat of tuberculosis (TB)— provide treatment to smear positive patients and watch them take it. In contrast with confident statements about how global TB would be brought under control when directly observed therapy, short course (DOTS) was introduced, TB continues to rise worldwide. The introduction of selected ...