Establishment and development of the National Tuberculosis Control Programme in Vietnam
METHODS: Data were obtained from the surveillance system established by the new NTP in 1986 and based on the principles now described as the WHO DOTS strategy.
RESULTS: The proportion of districts covered by the NTP increased from 40% in 1986 to almost 100% in 2000. The proportion of communes applying NTP guidelines increased from 18% in 1986 to 99.8% in 2000. The total number of tuberculosis cases notified increased from 8737 in 1986 to 89792 in 2000. Most of these are new smear-positive cases. Based on WHO estimations of the incidence rate, the proportion of new smear-positive cases detected and put on short-course treatment has been over 70% since 1996. Reported cure rates with short-course chemotherapy are consistently over 85%.
CONCLUSIONS: DOTS is feasible in a low-income, high-burden country. The main reasons for success were political commitment, a well-functioning health network, integration of tuberculosis control into the general health service at district level, a continuous supply of drugs and effective external support. Major challenges are long-term financial support, expansion to remote areas and vulnerable groups, definition of the role of the private sector, and future developments of the HIV epidemic and multidrug resistance.
Document Type: Regular Paper
Affiliations: 1: National Hospital of Tuberculosis and Respiratory Diseases, Hanoi, Vietnam 2: Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam 3: KNCV Tuberculosis Foundation, The Hague, The Netherlands 4: Medical Committee Netherlands-Vietnam, Amsterdam, The Netherlands 5: KNCV Tuberculosis Foundation, The Hague, The Netherlands; and Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Publication date: 01 February 2005
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