DOTS has five main components, which
can be summarized as government support, microscopes, observers,
medicines and records.
1. Government Support
The Malaysian Government has identified TB as a major public
health problem , and provides adequate funds and staffing
at both Federal and State level to tackle the problem.
The best way to diagnose people with infectious TB is to examine
their sputum by microscope. Smear-positive cases can spread
the disease to others. They are also more likely to die of
their disease if not treated. So, identifying the infectious
(smear-positive) cases is the highest priority for TB control
Taking a full course of treatment is the key to TB control.
This means that the TB control programme must guarantee a
continuous and uninterrupted supply of high quality TB medicines
to the patient.
TB treatment generally consists of a combination of drugs
given over a period of 4 to 6 months or more. A treatment
observer must watch a patient take his medicines for at least
2 full months of treatment, until the patient becomes non-infectious.
Without such supervision up to 30% of patients tend to fail
completing their treatment.
A good monitoring system is essential to make sure the patients
are taking their medicines. Proper registers must be maintained.
Failure to take medicines must be reported early and the reasons
for default identified. (? financial ). Action must be taken
to assist the patient , to ensure adherence to treatment.
Role of MAPTB
In Malaysia there is about 15% defaulter
rate amongst TB patients. Early action must be taken to reduce
this high rate.
MAPTB can play a very useful role in reducing this treatment
defaulter rate because of its:
|access to communities
|access to vulnerable
Guiding principles for MAPTB involvement in
The following principles underline the
best strategy for MAPTB involvement in the TB control programme.
The government has the primary responsibility for maintaining
and improving public health. MAPTB must work with the government
and become part of the National TB programme., and follow
MAPTBs role is to facilitate and support community action.
It will take 510 years or more to control TB. MAPTBs
role is to strengthen the communitys capability to maintain
services needed to fight TB.
Need to use the inherent skills of the MAPTB personnel (eg.
Advocacy, health education, case monitoring etc..) , and to
integrate with other closely related NGO activities ( eg.
Aids groups etc..)
MAJOR ACTIVITY of MAPTB in Malaysia
(where population needs information on TB)
Health education, information and communication.
Many people with TB lack awareness of the basic symptoms of
TB. Many dont know that diagnosis and treatment for
TB is provided free by Government.
KEY ELEMENTS FOR SUCCESS OF MAPTB INVOLVEMENT
Usually many groups are involved in the fight against TB.
Important to work together to avoid duplication of effort.
Sharing of information on new developments in TB control to
keep up to date, (newsletters, journals, conferences, meetings}.
Training courses should form a vital activity of MAPTB.
Different situations will require different approaches and
solutions. Within the National TB Policy guidelines MAPTB
should be innovative whenever required.
It will take a long time to eliminate TB as a public health
problem. MAPTB should avoid any actions that endanger its
own viability . Strong need to get new blood to ensure continuity.