Successes spur officials to seek expanded TB program

Photo by: Tracey Shelton
Tuberculosis patient Non Said, 63, lies in a bed Wednesday at the National Centre for Tuberculosis and Leprosy Control with a bag of ice on her chest to soothe the pain in her lungs.

The Phnom Penh Post
Friday, 17 July 2009
Khuon Leakhana

New plan would implement a community-based treatment strategy in 200 additional health-care centres by 2010.

CAMBODIA'S National Centre for Tuberculosis and Leprosy Control plans to implement a tuberculosis treatment programme that emphasises community participation in 200 new community health centres by 2010, the centre's director told the Post.

The program is titled Directly Observed Treatment Short Course, or DOTS.

"We plan to enlarge DOTS ... because this programme has been so successful," said Mao Tan Eang, the director. "At the moment, DOTS is being implemented in 500 health-care centres nationwide. We plan to be in 100 more health-care centres this year, and another 100 next year."

Mao Tan Eang said the project was slated to receive an additional US$7 million to $8 million in funding, adding that he was confident the centre would be able to meet its expansion goals.

Mao Tan Eang said he credited the community participation aspect of the DOTS programme with lowering Cambodia's tuberculosis rate.

"The DOTS programme worked so well because of the participation of volunteers from the community," he said. "The Ministry of Health officers and [the centre's staff] cannot accomplish the project alone."

Under the DOTS strategy, two or three volunteers from each commune educate local villagers, identify tuberculosis patients and directly observe their treatment and symptoms.

The system is believed to be more effective because it does not rely on individuals to recognise their own symptoms, Mao Tan Eang said.

About 90 percent of patients who receive DOTS treatment are cured, a figure that exceeds the World Health Organisation's target cure rate of 85 percent.

From 1997 to 2007, the tuberculosis rate dropped significantly in Cambodia, even though it was on the rise globally. In 1997, there were 428 cases per 100,000 people. That number dropped to 270 for every 100,000 people 10 years later.