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Directly observed treatment, short-course (DOTS, also known as TB-DOTS) is the name given to the tuberculosis (TB) control strategy recommended by the World Health Organization. According to WHO, "The most cost-effective way to stop the spread of TB in communities with a high incidence is by curing it. The best curative method for TB is known as DOTS." DOTS has five main components: * Government commitment (including political will at all levels, and establishment of a centralized and prioritized system of TB monitoring, recording and training) * Case detection by sputum culture, sputum smear microscopy * Standardized treatment regimen directly of six to nine months observed by a healthcare worker or community health worker for at least the first two months * Drug supply * A standardized recording and reporting system that allows assessment of treatment results History The technical strategy for DOTS was developed by Karel Styblo of the International Union Against Tuberculosis and L ...
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Tuberculosis
Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis. Around 10% of latent infections progress to active disease which, if left untreated, kill about half of those affected. Typical symptoms of active TB are chronic cough with blood-containing mucus, fever, night sweats, and weight loss. It was historically referred to as consumption due to the weight loss associated with the disease. Infection of other organs can cause a wide range of symptoms. Tuberculosis is spread from one person to the next through the air when people who have active TB in their lungs cough, spit, speak, or sneeze. People with Latent TB do not spread the disease. Active infection occurs more often in people with HIV/AIDS and in those who smoke. Diagnosis of active TB is ...
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World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of health". Headquartered in Geneva, Switzerland, it has six regional offices and 150 field offices worldwide. The WHO was established on 7 April 1948. The first meeting of the World Health Assembly (WHA), the agency's governing body, took place on 24 July of that year. The WHO incorporated the assets, personnel, and duties of the League of Nations' Health Organization and the , including the International Classification of Diseases (ICD). Its work began in earnest in 1951 after a significant infusion of financial and technical resources. The WHO's mandate seeks and includes: working worldwide to promote health, keeping the world safe, and serve the vulnerable. It advocates that a billion more people should have: universal health care coverag ...
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Sputum Culture
A sputum culture is a test to detect and identify bacteria or fungi that infect the lungs or breathing passages. Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, fresh morning sample is preferred for the bacteriological examination of sputum. A sample of sputum is collected in a sterile, wide-mouthed, dry, leak-proof and break-resistant plastic-container and sent to the laboratory for testing. Sampling may be performed by sputum being expectorated (produced by coughing), induced (saline is sprayed in the lungs to induce sputum production), or taken via an endotracheal tube with a protected specimen brush (commonly used on patients on respirators) in an intensive care setting. For selected organisms such as Cytomegalovirus or "Pneumocystis jiroveci" in specific clinical settings (immunocompromised patients) a bronchoalveolar lavage might be taken by an experienced pneumologist. If no bacteria or fungi grow, the culture is negative. If organisms ...
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Karel Styblo
Karel Styblo (26 November 1921, Vilémov (Havlíčkův Brod District), Vilémov – 13 March 1998, The Hague) was a Czech-Dutch physician. Internationally recognized for his work with tuberculosis (TB), he was a medical advisor to the Royal Netherlands Tuberculosis Association, and was named director of the International Union Against Tuberculosis and Lung Disease (IUATLD) in 1979. He is known as the "father of modern TB epidemiology" and the "father of modern TB control". Personal life Styblo was born in Czechoslovakia in 1921. Toward the end of World War II, he was imprisoned at the Mauthausen-Gusen concentration camp in Austria, where he contracted tuberculosis. After his recovery and release, Styblo entered Charles University in Prague. Obituaries say Styblo studied under Sir John Crofton at the University of Edinburgh, Scotland in the 1950s; the IUATLD says Crofton and Styblo worked together in Edinburgh in the early 50s. Crofton said in an interview that they met in 1960 while ...
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International Union Against Tuberculosis And Lung Disease
The International Union Against Tuberculosis and Lung Disease or The Union, is a global scientific organization headquartered in Paris with the stated goals to "improve health for people in low- and middle-income Countries". The Union focuses its work in three areas: Tuberculosis, Tobacco Control, and Lung and non-communicable diseases. The antecedents of The Union date to an 1867 meeting to discuss the tuberculosis plague, and include the former Central Bureau for the Prevention of Tuberculosis and the International Union Against Tuberculosis (IUAT). The Union no longer uses the acronym "IUATLD" as its short-form name. History Early pioneers were Robert Koch, Sir John Crofton and Karel Styblo. According to ''The Lancet'', in the 70s, Styblo "harnessed the meager resources of the International Union against Tuberculosis and Lung Disease and showed that, contrary to expert opinion, tuberculosis could be controlled in extremely poor countries: beginning in Tanzania, one of the poore ...
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World Bank
The World Bank is an international financial institution that provides loans and grants to the governments of low- and middle-income countries for the purpose of pursuing capital projects. The World Bank is the collective name for the International Bank for Reconstruction and Development (IBRD) and International Development Association (IDA), two of five international organizations owned by the World Bank Group. It was established along with the International Monetary Fund at the 1944 Bretton Woods Conference. After a slow start, its first loan was to France in 1947. In the 1970s, it focused on loans to developing world countries, shifting away from that mission in the 1980s. For the last 30 years, it has included NGOs and environmental groups in its loan portfolio. Its loan strategy is influenced by the Sustainable Development Goals as well as environmental and social safeguards. , the World Bank is run by a president and 25 executive directors, as well as 29 various vice ...
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Arata Kochi
is a Japanese physician and public health expert, who is the former director of the World Health Organization's malaria program. He had previously been director of WHO's tuberculosis programs for ten years. While at WHO, Dr. Kochi became known for developing—and then forcefully promoting—often politically unpopular global public health interventions to fight tuberculosis, malaria and HIV/AIDS. Tuberculosis Kochi is credited with promoting the Directly Observed Treatment Short course (DOTS) -the internationally recommended strategy for TB control that is recognized as a highly efficient and cost-effective strategy - for controlling TB as the most effective public health intervention of the decade, and after 1995 establishing more effective malaria control norms after 2005. Malaria Kochi is pro-DDT.Aaron SwartzRachel Carson, Mass Murderer? FAIR: Fairness & Accuracy In Reporting, 2007. References External linksAn Iron Fist Joins the Malaria Wars— by Donald G. McNeil, J ...
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Tom Frieden
Thomas R. Frieden (born December 7, 1960) is an American infectious disease and public health physician. He serves as president and CEO of Resolve to Save Lives, a $225million, five-year initiative to prevent epidemics and cardiovascular disease. He was the director of the U.S. Centers for Disease Control and Prevention (CDC), and he was the administrator of the Agency for Toxic Substances and Disease Registry from 2009 to 2017, appointed by President of the United States, President Barack Obama. As a commissioner of the New York City Department of Health and Mental Hygiene from 2002 to 2009 he came to some prominence for banning smoking in the city's restaurants as well as the serving of trans fat. Education Frieden was born and raised in New York City. His father, Julian Frieden, was chief of coronary care at Montefiore Medical Center, Montefiore Hospital and New Rochelle, New York, New Rochelle Hospitals in New York.
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Robert Koch Institute
The Robert Koch Institute (RKI) is a German federal government agency and research institute responsible for disease control and prevention. It is located in Berlin and Wernigerode. As an upper federal agency, it is subordinate to the Federal Ministry of Health. It was founded in 1891 and is named for its founding director, the founder of modern bacteriology and Nobel laureate Robert Koch. Tasks The Robert Koch Institute monitors public health. Its core tasks include the detection, prevention and combatting of infectious diseases and non-communicable diseases in Germany. The institute advises the specialist public and government, e.g. on preventing and tackling infectious disease outbreaks such as the COVID-19 pandemic, the swine flu pandemic in 2009 and the EHEC O104:H4 outbreak in 2011. The institute is also in charge of health monitoring and health reporting in Germany, covering non-communicable diseases: in large monitoring studies, RKI monitors the health status of ad ...
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Berlin, Germany
Berlin ( , ) is the capital and largest city of Germany by both area and population. Its 3.7 million inhabitants make it the European Union's most populous city, according to population within city limits. One of Germany's sixteen constituent states, Berlin is surrounded by the State of Brandenburg and contiguous with Potsdam, Brandenburg's capital. Berlin's urban area, which has a population of around 4.5 million, is the second most populous urban area in Germany after the Ruhr. The Berlin-Brandenburg capital region has around 6.2 million inhabitants and is Germany's third-largest metropolitan region after the Rhine-Ruhr and Rhine-Main regions. Berlin straddles the banks of the Spree, which flows into the Havel (a tributary of the Elbe) in the western borough of Spandau. Among the city's main topographical features are the many lakes in the western and southeastern boroughs formed by the Spree, Havel and Dahme, the largest of which is Lake Müggelsee. Due to its locat ...
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Hiroshi Nakajima
was a Japanese doctor known chiefly for his tenure as Director-General of the World Health Organization. Early life and education He was born in Chiba, Japan, on 16 May 1928. In 1955 Nakajima received his M.D. from Tokyo Medical University, Japan. He then studied in Paris. At some point after 1967, he obtained a PhD in medical sciences in Japan. Professional life Before 1974: France and Japan From 1956 or 1958 to 1967 Nakajima worked at the French National Institute of Health and Medical Research doing medical and pharmaceutical research. After his stay in France, he returned to Japan and became research director of Nippon Roche, a Japanese subsidiary of Hoffmann-La Roche. Early work at WHO Nakajima joined WHO in 1974 in the position of Scientist, Drug Evaluation and Monitoring. In 1976, he became Chief of the WHO Drug Policies and Management Unit. It was in this position that he played a key role in developing the concept of essential drugs, as Secretary of the first Ex ...
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Multi-drug-resistant Tuberculosis
Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications (drugs): isoniazid and rifampin. Some forms of TB are also resistant to second-line medications, and are called extensively drug-resistant TB ( XDR-TB). Tuberculosis is caused by infection with the bacterium ''Mycobacterium tuberculosis''. Almost one in four people in the world are infected with TB bacteria. Only when the bacteria become active do people become ill with TB. Bacteria become active as a result of anything that can reduce the person's immunity, such as HIV, advancing age, diabetes or other immunocompromising illnesses. TB can usually be treated with a course of four standard, or first-line, anti-TB drugs (i.e., isoniazid, rifampin, pyrazinamide and ethambutol). However, beginning with the first antibiotic treatment for TB in 1943, some strains of the TB bacteri ...
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