Without Prevention Programming, is DOTS Enough to Reduce the Incidence of Tuberculosis? Observational Analysis from Mayapuri Slum, New Delhi
Tuberculosis (TB) is one of the top ten largest contributors to global mortality: in 2012, an estimated 8.6 million people developed TB and 1.3 million died as a result (WHO 2013). India has been ranked as the country with the highest prevalence of TB (occupying 25.6% of the global total), with 2.2 million of the above-cited incidence cases occurring within the country (WHO 2013). As such, TB represents a serious public health problem within India’s borders. Furthermore, due to the epidemiology of the disease, those who are at highest risk are generally those at the lowest end of the economic spectrum. TB threatens to continually entangle the cycle of disease and poverty, with profound socio-economic effects.
Through the Direct Observed Treatment Short-course (DOTS) of the World Health Organization (WHO), excellent outcomes are being achieved worldwide through improved diagnostics and treatment of TB. However, the transmission of TB in high-risk areas throughout India continues to impede the success of DOTS and threatens the ability to control the burden of the disease. Incidence has increased in India since 2009 by 10%, from 2 million to 2.2 million (WHO 2013). DOTS’s primary focus is on the final stages of TB control, from diagnostics to completion of treatment. Prevention of TB is not, however, a primary focus in the DOTS programme; where present in policy, it is evident that prevention is lacking in practice. To reduce transmission – and thereby incidence – prevention needs to play a more extensive role in high-risk communities. While the DOTS programme is
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Jennifer Sault is currently finishing her B.Sc. in Microbiology & Immunology and International Development Studies. As a passionate humanitarian, she hopes to continue her career in charitable administration (as she has done with organizations such as End Poverty Now, Fair Trade Manitoba, Save Darfur Canada and, most recently, the 21st Century Leaders), in order to facilitate the implementation of health and education programs globally.