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Community Based Treatment of Tuberculosis in Rural Mozambique

DeGraaf, Brigitte (2012) Community Based Treatment of Tuberculosis in Rural Mozambique. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: Tuberculosis (TB) is a contagious disease commonly occurring in the lungs and is spread through the air usually by coughing. This infectious disease is particularly dangerous for individuals with compromised immune systems, like those with HIV/AIDS. Treatment for pulmonary TB infections is a regimen of multiple antibiotics lasting for at least six months.
Objectives: Despite complete coverage of treatment costs for TB patients by the Ministry of Health in Mozambique, incidence of the disease remains a high 174 cases per 100,000. The objective of this project is to evaluate World Relief’s (WR) community based TB directly observed therapy short-course (DOTS) treatment program.
Methods: Sixty-four TB treatment program volunteers within the three highest populated districts of the province of Gaza were interviewed and data were collected to identify accurate numbers of current community based DOTS patients per district. The central hospital in each district was also visited to directly acquire patient data and interview TB nurses.
Results: Currently a total of 153 TB patients are receiving community-based treatment in the three districts visited. On average, each village has one community based DOTS volunteer, and each volunteer oversees the treatment of up to three patients at a time. These volunteers reported positive community reception to TB prevention education yet felt inadequate with the community based DOTS system of treatment as a whole.
Conclusions: Based on the data collected and interviews completed, the community based DOTS program was effective in raising community awareness of TB prevention, as well as educating about TB as an infectious disease and TB treatment. The evaluation also concluded that the program lacked proper training and education maintenance for the volunteers in rural villages.
Implications for global health: Much potential exists for the community based DOTS program to successfully reduce TB incidence in Mozambique, particularly if WR is able to implement the necessary changes and improvements in volunteer training to its program in order to maximize its effectiveness in the community. The health problem of TB is of considerable public health significance because of the highly contagious nature of the bacteria. Without substantial steps taken to decrease the number of cases particularly in populations of greater susceptibility, the disease will only spread and mortality will increase. A successful decrease in incidence of TB infections in Mozambique would lead to a longer average life span and increased health in the population overall.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairTerry, Marthamaterry@pitt.eduMATERRY
Committee MemberNolan,
Committee MemberOjha, Anilano7@pitt.eduANO7
Date: 29 June 2012
Date Type: Completion
Defense Date: 11 April 2012
Approval Date: 29 June 2012
Submission Date: 19 April 2012
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 44
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Tuberculosis, DOTS, Community based, Mozambique, rural, evaluation
Date Deposited: 29 Jun 2012 17:53
Last Modified: 15 Nov 2016 13:57


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