Adopt TB approach to tackle chronic diseases
The framework for tuberculosis control should be adapted to counter Sub-Saharan Africa's growing burden of non-communicable diseases (NCDs), write Anthony D. Harries and colleagues in PLoS Medicine.
The proportion of deaths in the region attributed to NCDs — including obesity, diabetes, heart disease, asthma and mental illness — was 20 per cent in 2001, but is set to double by 2020.
NCDs are poorly managed and poorly followed up, even in specialist centres.
This can be rectified by applying tuberculosis (TB) control frameworks such as directly observed therapy, short-course (DOTS) to NCDs.
DOTS has been incorporated in 190 countries, providing standardised, anti-TB drug treatments for 26 million people, most of them in developing countries.
A key feature of DOTS is its "registration, recording and reporting" format, which keeps track of the number of patients signed up for treatment and records end-of-treatment outcomes. This enables the provision of uninterrupted drug supplies.
This programme has also been adapted for HIV treatment in Malawi.
"A simple, standardised system of diagnosis and treatment has the advantage that it can be rolled out and implemented in all parts of the country, thereby improving access and facilitating follow-up for all patients in need," the authors write.