Tuberculosis

Excerpt

Despite the availability of drugs to cure tuberculosis (TB) since the 1940s, TB remains an important cause of death from an infectious agent, second only to the human immunodeficiency virus, or HIV (WHO 2004f). TB control is high on the international public health agenda, not only because of the enormous burden of disease, but also because short-course chemotherapy (SCC) is recognized as one of the most cost-effective of all health interventions (Jamison and others 1993). That recognition is partly attributable to an influential series of studies done in three of the poorest countries of southeastern Africa (Malawi, Mozambique, and Tanzania), which suggested that a year of healthy life could be gained for less than about US$5 (de Jonghe and others 1994; Murray and others 1991). This evidence has been central to the global promotion of the DOTS strategy, the package of measures combining best practices in the diagnosis and treatment of patients with active TB, in which direct observation of treatment during SCC is a key element (WHO 2002a, 2004c).