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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|
|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|
|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.|
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.
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.
|Specific objectives/indicators||no data|
|Total foreseen budget||EUR 622,000|
Total implementation costs
(for completed projects, if available)
Conversion to € was done on
(according to the relevant
exchange rate at
Infoeuro Monthly Files)
|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|