![]() The DOTS strategy was implemented in Romania building on the experience that had been gained in the pilot projects of Iasi County (Romania), where a protocol based on WHO recommendations (DOTS Strategy) was developed 1, 2, 8. The aim of the present study was to demonstrate the effectiveness of the DOTS strategy implementation in reversing the epidemiological TB trend in Romania, based on programmatic data analysis. yr −1 were recorded, which corresponds to >100 TB cases per 100,000 population 7, 8.Over the past 20 yrs, Romania has been reported to have one of the highest adult TB rates in the whole of Europe from 1995 to 2007 >23,000 cases To date, no published evidence is available on the effectiveness of DOTS in reducing the incidence of TB within countries in the European “hot spots”. The new Stop TB Strategy incorporates all the principles of the DOTS strategy (as the first element), while offering further new elements (patient support, quality diagnosis and treatment for all patients, including MDR-TB, extensively drug-resistant-TB and TB/HIV co-infected cases), and is represented by all care providers, who are essential to improving TB control in difficult settings 3, 4.Īlthough evidence on the successful implementation of DOTS in Asia and Latin America exists 5, its long-term effectiveness was recently questioned 6. The Stop TB Strategy consists of the following six elements: 1) pursue high-quality DOTS expansion and enhancement 2) address TB/HIV, multidrug-resistant (MDR)-TB and other challenges 3) contribute to health system strengthening 4) engage all care providers 5) empower people with TB, and communities and 6) enable and promote research. 70% detection of SSP-TB cases and 85% successful treatment of cases) and the TB-related Millenium Development Goal (a steady decline in TB incidence) 1, 2, WHO developed a broader approach that is embodied in the new Stop TB Strategy 1. Moreover, in order to achieve the World Health Assembly targets (WAT e.g. The DOTS strategy, which consists of five key elements (government commitment, diagnosis through bacteriology, standardised and supervised treatment, uninterrupted drug supply, and regular programme monitoring), proved to be one of the most cost-effective strategies ever initiated 1. In the early 1990s, the World Health Organization (WHO), after recognising that TB is a global emergency, advocated the global adoption of the DOTS (directly observed treatment, short-course) strategy. Tuberculosis (TB) control is based on rapid diagnosis and effective treatment of infectious, sputum smear-positive (SSP) cases, and is aimed at breaking the chain of transmission and preventing selection of resistant mutants 1. those belonging to the former Soviet Union) might be able to reach the World Health Assembly Targets and curb the burden of tuberculosis. The success story in Romania suggests that other middle-income, high-incidence countries ( i.e. The key programme indicators began declining and the World Health Assembly targets were reached (79% case-detection of new sputum-smear positive cases and 85.5% success rate in new culture-positive TB cases), 7 yrs after initiation of the DOTS expansion. Internationally agreed definitions were used. Key programme indicators were analysed from 1998 to 2007, and included DOTS coverage, case-detection rate, treatment success and overall incidence of notified cases. The present study aimed to demonstrate the effectiveness of the strategy implementation in reversing the epidemiological TB trend in Romania based on programmatic data analysis. At present, no published evidence is available on the effectiveness of the DOTS (directly observed treatment, short-course) strategy in reducing the incidence of tuberculosis (TB) within a country in the European “hot spots”.
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