Development of a model of Community DOTS in Pyinmana township, Myanmar

Abstract

Background:
National TB prevalence survey conducted in 2009 revealed that the prevalence of TB is more than WHO expected. Therefore, NTP needs to strengthen all measures of case finding. In July 2011, NTP decided to introduce Community DOTS in order not only to treat but also to find more TB cases in the communities. The most distinctive feature of this Community -DOTS is no monetary incentives for the community health volunteers (CHVs) even though some INGOS already working on Community- DOTS in Myanmar provide high monetary support.
Objective:
1.To identify facilitating and hindering factors at the initial phase of development of
Community-DOTS.
Method:
NTP gave Advocacy and training in accordance with the guideline for referral of TB suspects, health education and provision of DOT. Total (29) CHVs (10 from rural, 19 from urban) were trained. Monthly evaluation meeting, supervisory visits were regularly conducted.
Results:
During the first (7) months, (21) TB suspects were referred while health education was given to the total of 838 people in their community. Out of 21, 12 (57%) were confirmed as TB cases and provided DOT. Only one patient was found out of (77) TB suspects by doing contact tracing. During evaluation meeting, we found that activities of CHWs are limited because sputum transport charges from their villages to township were needed. Selection criteria for the volunteer is crucial to present the drop out and yield of TB cases.
Conclusion and recommendation:
Technical support by the NTP staff facilitates CHVs' activities in the initial stage of Community-DOTS. Some CHVs face the challenges to gain the trust of TB patients and the communities. Selection of the CHVs is vital role in successful Community – DOTS.