Key Achievements in Tuberculosis: Fiscal Year (FY) 2001
Applied DOTS Research in Brazil
Over the
last two years, USAID, in partnership with the
Gorgas Memorial Institute, has conducted applied
research to adapt the directly observed treatment, short course (DOTS) approach for use in
Brazil. The program has achieved an 84 percent
treatment success rate in a rural area adjoining
Rio de Janeiro, a significant achievement in a
country with a 40 percent default rate of treatment
completion. In 2002, this model program will
expand to other parts of Rio de Janeiro.
Battling Multidrug-Resistant TB
USAID is
working with WHO, the International Union
Against TB and Lung Disease, and the Gorgas
Institute on surveys of multidrug-resistant TB
(MDR-TB) in Cambodia, India, and Morocco. The survey results will be used to monitor the
effectiveness of DOTS programs and prevent the further emergence of MDR-TB.
Developing a Rapid TB Diagnostic
USAID supported the development of a simple diagnostic test for rapid diagnosis of Mycobacterium tuberculosis, the bacterium that causes tuberculosis disease. In 2002, the diagnostic will be evaluated in well-controlled prospective field trials in several sites in Africa, Asia, Europe, and Eurasia.
Expanded TB Efforts in Eastern Europe and Eurasia
During the last five years, USAID has
expanded its TB efforts in 11 countries in Eastern
Europe and Eurasia, including Russia, the Central
Asia Republics, Ukraine, Latvia, Lithuania,
Estonia, and Kosovo. A USAID-supported treatment
and control program in two Russian districts demonstrated the use of DOTS as an effective
TB control strategy. In Orel district, a six-month
trial achieved an 88 percent treatment success
rate in new TB patients and a 60 percent
success rate in re-treatment patients. In Ivanovo
district, a study investigating treatment failure
determined that in addition to MDR-TB, treatment
interruption was a major cause of concern.
Other achievements include comprehensive training
of more than 20 physicians in Latvia in treating
MDR-TB.
Global TB Drug Facility Country Assessments
USAID participated in GDF country assessments in Moldova, Tajikistan, Kenya, and Uganda. Recommendations for improving systems performance were developed to help ensure that drugs procured under the GDF will reach patients as intended.
Private-Sector TB Control
In order to expand the use of DOTS in high-burden countries, USAID is beginning to explore ways to improve the quality of TB control in the private sector. With USAID support, CDC and the Philippines Coalition against Tuberculosis have begun developing model programs to improve private-sector TB treatment.
STOP TB in Cambodia, Vietnam and the Philippines
With USAID support, the STOP TB Initiative in WHO’s Western Pacific Region helped Cambodia, Vietnam, and the Philippines expand their TB control efforts. USAID provided technical support for developing five-year strategic plans and budgets for TB control; monitoring DOTS implementation; developing approaches to address HIV/TB co-infection; monitoring the quality of TB drugs; and strengthening drug supply management.
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