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WHO program could slash Taipei's tuberculosis rate

Taipei City Government's health department yesterday said that a program adopted by the WHO may help the city in its bid to better prevent and cure tuberculosis infections over the next 10 years.

The Directly Observed Treatment, Short-course (DOTS) strategy was first used in the US in the 1990s and earlier this year the WHO adopted the strategy as part of its 10-year global STOP TB (tuberculosis) project. DOTS is a short-term treatment where patients take medication with direct observation by the medicine deliverer.

Ever since the WHO decided on its global scheme this January in response to increased cases of tuberculosis in developed and developing countries, Taiwan has volunteered its participation despite having no official affiliation with the organization.

According to statistics from the Department of Health, 15,000 people were infected with the illness in 2003 and it was a major cause of death in Taiwan between 2000 and 2003.

Chief of the city's health department Sung Yan-jen (宋晏仁) said the basic concept of DOTS was to "deliver the medicine, watch the patients take the medicine and watch them leave afterwards."

According to Sung, treating the disease is a painful process and most patients tend to avoid the treatment because of its serious side effects, but he told the reporter that to cure the disease successfully, the key lies in ensuring the patient receives the medication.

"DOTS is an observatory mechanism, not a forced one," he said, "By finding out there is something wrong with the patients earlier, the public health system will be able to solve their problems and complete the treatment."

Modeled on the US system, the city's health department initiated a trial of DOTS in March 2004, focusing on the elderly, homeless people and uncooperative patients.

The department made 12,000 observations between March and August 2004 and the success rate after 12 months of treatment was 94.5 percent and 99 percent after 18 months, according to the department's news release.

Sung said that although the number of people with tuberculosis in Taipei had dropped from 2,000 six years ago to 1,300 or so by 2004, the department still needed to "put greater effort into" fighting the illness.

With a NT$180 million (US$5.45 million) budget from the Bureau of National Health Insurance, Sung said the department was now able to hire five more people to deliver the medicine, with each person responsible for 10 patients per day.
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