Strategic analysis of tuberculosis prevention and control actions in Brazil and Ethiopia: one size fits all?

OBJECTIVES

This study aimed at conducting a strategic analysis of Tuberculosis prevention and control actions in Brazil and Ethiopia, looking at the potential of directly observed treatment short-course strategy (DOTS) and community DOTS in both countries.

METHODS

Literature review was conducted using PubMed, Medline-Ovid, EMBASE, and SCIELO databases. The reviewed terms were Tuberculosis, prevention and control and Brazil (or Brasil) or Ethiopia (or Etiopia). Study's eligibility included article's title or abstract in English or Portuguese and comprised the following Tuberculosis policy components: management; care; communication, and social mobilization; training and professional development; epidemiological surveillance, and monitoring and evaluation. The study identified, compared, and analyzed the challenges and recommendations reported in the literature.

RESULTS

Although DOTS was not able to address all the difficulties regarding Tuberculosis control and prevention, it contributes to overcome challenges identified in the literature review. Decentralizing DOTS in Ethiopia and implementing DOTS in Brazil were key recommendations to overcome problems of access and treatment default.

CONCLUSIONS

DOTS and Community DOTS cannot solve every identified Tuberculosis challenge, but together they complement each other. Both strategies need to be tailored to site's challenges.