Directly Observed Treatment: Our Impact

{Photo credit: MSH staff}Photo credit: MSH staff

Kabul is the largest city in Afghanistan, with a population of over 3 million people. The population density leads to overcrowding and strains health systems and infrastructure. In a country with a high tuberculosis (TB) burden, TB service delivery has been a particular challenge. In 2009, only 22 of the 106 existing public and private health facilities in Kabul provided partial TB services. TB case detection was only 26 percent, and the treatment success rate was 49 percent. All TB indicators for the city consistently fell below national targets.

{Photo credit: MSH staff/Afghanistan}Photo credit: MSH staff/Afghanistan

Dr. Mohammad Khakerah Rashidi is Country Representative of Management Sciences for Health (MSH) Afghanistan and Project Director of USAID's Challenge TB in Afghanistan. Rashidi also serves as First Vice Chair of the Country Coordinating Mechanism (CCM) Afghanistan (Global Fund) and is a Senior Lecturer at Zawul Institute of Higher Education. Earlier in his career, Rashidi says he was the “only medical doctor for more than a million people.” He spoke to MSH about its TB work in Afghanistan in the context of a fragile state.

Afghanistan is one of 22 countries that have been designated as having a high burden of tuberculosis (TB). Each year, roughly 11,000 Afghans die from TB--many of these deaths occur in rural regions where residents have limited access to TB screening and treatment.

Nurse Mpala Muhungu in Lubudi, with two children diagnosed with TB following the DRC-IHP training. {Photo credit: MSH.}Photo credit: MSH.

Nearly one in two cases of active tuberculosis (TB) went undetected in the Democratic Republic of Congo in 2010, due to inadequate screening for the disease.

In Kalenda, a Congolese woman diagnosed with tuberculosis takes her medication following the “Directly Observed Treatment, Short-Course” approach, also known as DOTS. {Photo credit: MSH.}Photo credit: MSH.

Tuberculosis (TB) is a leading cause of death in Democratic Republic of the Congo, in part, because of a lack of access to diagnosis and treatment for those suffering from the disease.

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