More than Ten Years of DOTS in Bosnia and Herzegovina

Abstract

Directly Observed Therapy Short-course (DOTS) is composed of five distinct elements: political commitment, case detection through quality-assured bacteriology; drug supplies; surveillance and monitoring systems and use of highly efficacious regimens; and direct observation of treatment. DOTS produces cure rates of up to 95 percent even in the poorest countries and prevents the development of Multi-Drug Resistant Tuberculosis. National TB Programme (NTP) has been started to introduce in 1994 according to DOTS principles in B&H with central and regional levels. At central levels there are national TB coordinators, and in all Cantons/Regions there are regional TB Coordinators. During intensive phase of therapy, patients are hospitalized. In the second phase of therapy, patients are treated in anti-tuberculosis dispensaries and some of them by a responsible member of the family (family supervision). There are several weaknesses in implementation of DOTS in B&H: TB case detection was not fully implemented in all medical services. Registration of TB cases in some facilities, there is no official central recommended registry, individual reporting for treatment outcomes and establishing a reliable monitoring and evaluation system. Application for 6 round of The Global Fund to Fight AIDS, TB and Malaria (GFATM) had been finally approved and signed for B&H in October 2007. These grants would repair some implementation gaps and improve DOTS strategy in B&H. DOTS - Directly Observed Therapy Short-course, usual standard abbreviation for TB strategy all over the world.

Keywords

• DOTS strategy
• Bosnia and Herzegovina