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TB11: Expansion of DOTS for control of TB in Lithuania

Project title TB11: Expansion of DOTS for control of TB in Lithuania
Database CBSS Task Force on Communicable Disease Control in the Baltic Sea Region
ID in the source database 69
Thematic area
  • Primary Health Care
  • Prison Health
  • Tuberculosis
Topic Baltic Sea Region
Project geographical area Lithuania
Substate level / administrative units /regions no data
Lead partner (organisation) Ministry of Health of the Republic of Lithuania
Lead partner (owner or/and project manager) no data
Partner organisations Reykjavik Centre of Public Health
Start date 2002-07-02
End date 2005-12-31
Duration (months) 42
Target audience National and local health and TB authorities; personnel resposible for quality assurance of diagnosis and treatment of TB; N/R reference laboratories; personnel responsible for registry, laboratory and curative services.
Summary The aim of the proposed project is to expand and consolidate the DOTS strategy country-wide by the end of 2005. The objectives are to cure 85% of newly detected cases and to examine the sputum of patients as a routine in the procress of diagnosis and follow up in order to increase bacteriological confirmation of cases and cure. In order to achieve this, political commitmment is essential; for strenthening of TB microscopy centers, integration of TB diagnostics and ambulatory treatment with primary health care (PHC) services and for strengthening of TB program management and supervision of services. Social assistance to TB patients must be provided. DOTS training corses for TB specialists, general practitioners (GPs), nurses and prison medical staff must be continued and registration, recording and reporting still needs to be improved. Communication with international organizations such as the World Heatlh Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD) needs to be continued.

A compulsory Health Insuranse Fund will cover approximately 90% of the expenses for TB diagnosis and treatment. External funds are needed for approximately 10% of the expenses for TB diagnosis and ambulatory treatment (especially in PHC institutions). The aim is to involve GPs and community nurses in DOTS implementation in order to improve access to TB diagnosis and treatment. Community nurses and GPs trained in DOTS will visit TB patients at home and observe swalloving of TB drugs. Some patients will come to GP offices (policlinics) and their treatment will be directly observed at least 3 times a week. External finanical support is needed to cover the cost of outreach services and for provision of continuing education and training on DOTS strategy.

The main focus of the project will be:
1. Laboratory services for bacteriological confirmation of TB cases.
2. Provision of directly observed short course chemotherapy.
3. Strengthening of the new recording and reporting system.
4. Supervision of services for quality assurance.
5. Training of health personnel.
Background Incidence of tuberculosis (TB), mortality, drug resistance and multidrug resistance (MDRTB) increased rapidly in Lithuania after independence in 1990. In 1998, 3176 TB cases were detected (81 per 100.000 population) whereof 2826 (89%) were reported as new cases and 350 (11%) as relapses.

The Lithuanian National Programme for the Prevention and Control of TB was approved on March-12 1998. The WHO recommended DOTS strategy was implemented in three pilot areas (Varena, Kelme and Kaisiadorys) in 1998-2000. In 2001, DOTS had been expanded to cover more than 20% of the Lithuanian population. In 2000, 37% of all newly diagnosed microscopy and culture positive TB cases were reported from DOTS areas. Cure rate in DOTS areas in 2000 was more than 80%

The TB epidemic seems now to be levelling off with 2606 new cases reported in 2001 as opposed to 3176 in 1998. This needs to be confirmed however when recording and reporting has been strengthened countrywide. The prison system reported 156 new cases in 1998 and 98 in 2000, whereof only 28% were confirmed by culture.
Objectives
  • External technical support
  • Improving early detection of TB based on bacteriology
  • Expansion of DOTS outreach services
  • Subsidising treatment (drugs) and providing support for TB patients on ambulatory treatment in order to improve treatment results
  • Expansion of the DOTS system for data collection and management
  • Training of personnel involved in the care of TB patients
  • Specific objectives/indicators no data
    Results no data
    Total foreseen budget EUR 622,000
    Total implementation costs
    (for completed projects, if available)
    no data
    Conversion to € was done on
    (according to the relevant
    exchange rate at
    Infoeuro Monthly Files)
    no data
    Financing agencies / organisations no data
    Project's URL / project's website no data
    Papers associated with this project no data
    Further information no data
    Last posted: on 2009-08-25 at 10:25:41

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