TB kills 1.7 million people every year. Of these, almost half a million
people are co-infected with HIV. One in three of the global population
-- about 2 billion people -- have latent TB infection, but only about 10%
of them will go on to develop the disease.
TB is spread by infectious droplets -- through coughing, sneezing, or
spitting. It thrives in conditions of poverty and overcrowding. A person
with active TB can infect an average of 15 people a year.
Every year there are about 8 million new TB cases and the poorest and
most vulnerable are at highest risk. The disease strikes people during
their most productive years. Three out of four deaths occur between
the ages of 15 and 54.
Millions of TB deaths could be prevented through the widespread use
of DOTS, an inexpensive strategy for the detection and treatment of
TB. The strategy can detect and cure TB even in the poorest countries.
In 1997, the average treatment success rate worldwide was almost 80%.
However, less than 25% of people who are sick with TB are treated through
the DOTS strategy.
DOTS is a 5-pronged strategy for TB control involvin
While DOTS has been shown to be successful in many different settings
worldwide, the effectiveness of this strategy is facing two new challenges:
the spread of multidrug-resistant TB (MDR-TB) and the co-epidemic of
TB/HIV. To address these challenges, WHO and its partners have established
two initiatives: DOTS-Plus for MDR-TB and proTest for TB/HIV.
DOTS-Plus is a pilot strategy to address multidrug-resistant
tuberculosis (MDR-TB), defined as resistant to at least isoniazid and
rifampicin, the two most powerful TB drugs. DOTS-Plus includes the five
elements of the DOTS strategy and in addition takes into account specific
issues that need to be addressed in areas where there is a relatively
high prevalence of MDR-TB. The aim is to assess the feasibility and
cost-effectiveness of treating MDR-TB with these second-line drugs in
proTest, a new initiative in sub-Saharan Africa, is promoting
voluntary counselling and testing for HIV as an entry point for a range
of HIV and TB prevention and care interventions. Two-thirds of the people
living with HIV worldwide are in sub-Saharan Africa and over 90% do
not know they are infected. The region accounts for 70% of all co-infections
with TB/HIV .