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Biomedical subjects

P de Colombani

Publications and source records attributed to P de Colombani.

6 recordsLinked to original sources

European framework to decrease the burden of TB/HIV.

Tuberculosis (TB) in Europe is declining in countries in western and central Europe, but the burden is still high and increasing in eastern Europe. HIV/AIDS is increasing dramatically in eastern Europe. HIV-related tuberculosis (TB/HIV) morbidity and mortality are expected to accelerate significantly in the future. This framework aims to guide European countries in developing their national plan for reducing TB/HIV morbidity and mortality. It results from an extensive consultation process undertaken by the World Health Organization Regional Office for Europe and by those responsible for HIV/AIDS and TB programmes and their partners. It builds on strategies developed globally and in Europe for TB control and for HIV/AIDS prevention and care. This framework sets out the rationale for effective collaboration between HIV/AIDS and tuberculosis national programmes. It identifies five strategic components (political commitment, collaborative prevention, intensified case-finding, coordinated treatment and strengthened surveillance) and eight key operations (central coordination, policy development, surveillance, training, supply management, service delivery, health promotion and research).

Europe↗

Tuberculosis and patient gender in Bangladesh: sex differences in diagnosis and treatment outcome.

SETTING: The public health sector of Bangladesh. OBJECTIVE: To assess gender differences in access to tuberculosis diagnosis and in tuberculosis treatment outcome in Bangladesh. METHODS: Information on the age and sex of a sample of patients in 1997 was collected from out-patient registers and tuberculosis laboratory and treatment registers in 59 thanas in three divisions in Bangladesh. RESULTS: The female/male ratio was 0.79 among 42,877 out-patients with respiratory complaints, 0.51 among 5,665 tuberculosis suspects undergoing sputum smear microscopy, 0.36 among 869 tuberculosis suspects with positive sputum smears, and 0.35 among 5,632 patients registered for tuberculosis treatment. Treatment was successful (cured or treatment completed) in 86% of female and 84% of male patients. CONCLUSION: Women in Bangladesh appear to have less access to public out-patient clinics than men, and if they present with respiratory symptoms they are less likely to undergo sputum smear examination. If examined, women are less likely than men to be smear-positive. No gender bias was observed in tuberculosis treatment outcome. It is recommended to focus further research on exploration of sex differences in the incidence of respiratory conditions, identification of constraints among women in accessing out-patient clinics and verification of the quality of sputum submitted by women for examination.

Adolescent↗

Tuberculosis and health sector reform in Bangladesh.

In 1998 the Government of Bangladesh changed its health and population sector strategy from a project-oriented approach (the Fourth Population and Health Project--FPHP) to sector-wide management (the Fifth Health and Population Sector Programme--HPSP). This article describes the development and achievements of the tuberculosis programme during the FPHP, and discusses the potential opportunities and challenges anticipated by the programme from the reformed health service delivery of the HPSP. 'Further strengthening of tuberculosis and leprosy control services' was one of the 66 projects of the FPHP. As part of the FPHP, the National Tuberculosis Programme policy was revised in 1992 and the project was implemented in phases. By mid 1998, 90% of the population was covered, and more than 200,000 tuberculosis cases had been diagnosed and treated with 80% success. We describe the reasons for this success and analyse the pitfalls of the project. The objective of the reforms in HPSP is to provide cost-effective, sustainable, quality services to those in need through an essential service package that includes control of communicable diseases such as tuberculosis and leprosy. Tuberculosis services will become more accessible as community clinics deliver essential health services for every 6000 population. Non-public health care providers, who contribute significantly to health services in the country, will be involved in service delivery. The main challenge is to maintain the quality of successful projects, such as tuberculosis control, during the transition period.

Bangladesh↗

Review of national tuberculosis programmes: the experience in Bangladesh.

Tuberculosis control efforts should be evaluated periodically to assess progress made by national programmes and to plan for the future. Simple and reliable tools are required for such assessments. This paper summarises the methodology and results of the review of the national tuberculosis programme in Bangladesh conducted in 1997. The authors conclude that similar reviews would not only help to verify the reports from the routine recording system, but would also assist policy development and future planning.

Bangladesh↗