oa South African Health Review - Tuberculosis : priority programmes



Although considerable progress has been made with tuberculosis control efforts in South Africa since 2000, there is little sign that the epidemic is abating. <br>The South African government adopted the resolutions of the March 2000 Amsterdam Declaration to Stop TB and a strategic plan for 2001-2005 for combating the tuberculosis epidemic is now in place. <br>Directly Observed Treatment Short-course (DOTS) activities have been expanded within South Africa. the percentage of districts operating as DOTS Demonstration and Training Districts increased from 66% in 1999 to 87% in 2002. the aspiration is to achieve full DOTS coverage in the country by the end of 2002. <br>However, efforts to provide effective TB treatment using DOTS at district and facility level are constrained by numerous factors. Whilst the national and provincial strategic plans provide a framework for addressing constraints in a systematic manner, effective TB control relies on the commitment of health workers and managers at facility and district level. A number of innovative approaches to improving TB control at these levels are therefore included in the chapter. <br>The Department of Health HIV / AIDS and TB Control Directorate also hopes to roll out integrated management of TB and HIV within the country based on lessons learnt from the four TB / HIV pilot sites that have been operational since 1999. the plan is to establish at least one training site for integrated TB / HIV management in every province by the end of 2002. <br>Partnerships with other stakeholders in TB control, at both international and local levels have also been strengthened. Several international agencies provide both financial and technical support to the National TB Control Programme. Examples of how local non-governmental organisations (NGOs) are participating in TB care delivery in the country are provided highlighting some of the challenges these organisations face. <br>Despite this progress however, the cure rate of 64% for new TB patients for 2001 still remains far below the internationally and nationally accepted target of 85%. There should be no room for complacency and sustained effort is required to ensure that better TB management at national level translates into improved outcomes for patients at primary health care level.


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