Sabiiti Wilber
University of St. Andrews, St. Andrews, UK.
East Afr Health Res J. 2017;1(1):2-7. doi: 10.24248/EAHRJ-D-16-00364. Epub 2017 Mar 1.
By 2000, 5 East African Community (EAC) member states-Uganda, Kenya, Tanzania, Rwanda, and Burundi-had adopted the World Health Organization's (WHO's) policy of directly observed treatment short-course (DOTS) for tuberculosis (TB). This policy is meant to speed up the control of TB through effective diagnosis and treatment. However, the rate of reduction of TB burden has been slow, and as of 2016, 3 EAC member states-Uganda, Kenya, and Tanzania-are still categorised as high TB burden countries. We analysed WHO's and drew key lessons to inform policy and practice for effective control of TB. From the report, we acknowledge the existence of national TB control policies operationalised through national TB control programmes in all EAC member states. However, we found persistent underfinancing of the TB control programmes; low national coverage of TB diagnostic and treatment services, meaning that many TB cases are most likely going undetected; and deaths due to lack of treatment. We also found poor reporting practices; for example, there was no data on the number of cases detected with rapid diagnostics in Uganda and Tanzania, which was unexpected since there are more than 170 Xpert MTB/RIF machines for rapid diagnosis of TB in the 2 countries. We recommend comprehensive implementation of existing TB policy, including adequate financing, universal access to diagnosis and treatment, and socioeconomic empowerment of affected communities, all of which are critical for ending TB in East Africa and the world at large.
到2000年，东非共同体（EAC）的5个成员国——乌干达、肯尼亚、坦桑尼亚、卢旺达和布隆迪——已采纳世界卫生组织（WHO）的结核病直接督导下的短程治疗（DOTS）政策。该政策旨在通过有效的诊断和治疗加速结核病控制。然而，结核病负担的下降速度一直很慢，截至2016年，3个东非共同体成员国——乌干达、肯尼亚和坦桑尼亚——仍被归类为结核病高负担国家。我们分析了世界卫生组织的相关内容并汲取了关键经验教训，以为有效控制结核病的政策和实践提供参考。从报告中，我们认识到所有东非共同体成员国都通过国家结核病控制规划实施了国家结核病控制政策。然而，我们发现结核病控制规划的资金一直不足；结核病诊断和治疗服务的全国覆盖率较低，这意味着许多结核病病例很可能未被发现；以及因缺乏治疗导致的死亡。我们还发现报告做法不佳；例如，乌干达和坦桑尼亚没有关于通过快速诊断检测出的病例数的数据，鉴于这两个国家有170多台用于结核病快速诊断的Xpert MTB/RIF机器，这是出乎意料的。我们建议全面实施现有的结核病政策，包括充足的资金、普遍获得诊断和治疗以及增强受影响社区的社会经济权能，所有这些对于在东非乃至全世界终结结核病都至关重要。
