DOTS in Zimbabwe
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To the best of my knowledge, Zimbabwe does not use DOTs. Can
somebody from Zimbabwe comment on this...
Dear Charles,
we are two Italian doctors and we are working in Zimbabwe
since one year. We are based in Chegutu District in Mashona-
land West and we work in the District Hospital. We would like
to comment on your correct observation: since we arrived here,
in June 1997, we are struggling to improve the peripheral man-
agement of TB, with no results. Unfortunately, not only is
DOTs not used in our district, but at peripheral level the
nurses refuse to take sputum samples on the basis that "it is
not safe for the staff". To worsen the situation, there is no
possibility to have sputum cultures, since the referral Lab
that previously was taking our samples is now overloaded and
refuses to do it or delays the results over any reasonable
time.
Moreover, the local doctors often put patients on TB treatment
without performing a sputum exam, only relying on the X-Ray.
In this way many patients are put on "TB trial" and they often
default treatment when they are better, increasing the drug-
resistance in the area. To speak about the problems of DOTs,
we think that there would be practical problems in the Commer-
cial Farms area, where there are no clinics in the farms, but
in the rural area, where there are lots of clinics at walking
distance from the villages, it could be easily done. We do not
know what is happening in the rest of the country, but we
heard from some colleagues having the same problems also in
other districts.
We think that, if DOTs would be implemented at least in the
rural areas, and sputum samples collected at peripheral level,
and culture results available, the situation would be much
better.
C. Appetito
Chegutu / Zimbabwe
mailto:cappetito@healthnet.zw
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