International and national scenario of directly observed treatment short course (DOTS) in tuberculosis control policies
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Abstract
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis that has a huge social impact. According to the World Health Organization (WHO) report published in 2010, an estimated 14 million people worldwide are infected with active tuberculosis (TB) with an increasing concentration in countries with low social development. In 1993, WHO published Directly Observed Treatment Short Course (DOTS) Guidelines, that are considered the most effective strategy on tuberculosis control in large scale. DOTS was implemented in Brazil in 1998, prioritizing cities with high tuberculosis incidence rates. Studies sustain that a very significant progress has been made regarding diagnosis, treatment and screening of tuberculosis. The objective of this study was to review literature on tuberculosis control policies around the world and in Brazil, emphasizing the DOTS strategy. Technical documents from WHO and Brazilian Health Ministry as well as scientific articles from Pubmed and Scielo databases from January 1993 to January 2010 were screened using as keywords: DOTSplus, treatment, HIV, tuberculosis and DOTS. Twenty one articles were selected from 178 publications and 11 technical documents. The literature emphasized tuberculosis control policies in Brazil and around the world, characterizing the development until today. It is concluded that strategies such as DOTS require a long period of adjustments by health professionals and local governments. Improvements have already been shown in tuberculosis rates with those policies.
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