1. Status of TB Operations. .
Status of TB Operations
(Region of the Americas, 2004)
Regional Program on Tuberculosis
Status of TB Operations (Region of the Americas, 2004)

2. Status of TB Operations (Region of the Americas, 2004)
Elements of the DOTS Strategy
Political commitment
Bacteriological diagnostic capacity
Regular supply of medications and supplies
Directly Observed Treatment Strategy
Information system
Registries
Training, Supervision, IEC, Evaluation
Status of TB Operations (Region of the Americas, 2004)

3. Trend of DOTS Coverage (% pop., 1999–2003)
Status of TB Operations (Region of the Americas, 2004)

4. Current Status of the DOTS Strategy (Americas, 2002)
DOTS Coverage:
73% of the population
< 10% coverage
< 10% -<49%
>50-90%
Total coverage
No DOTS
Status of TB Operations (Region of the Americas, 2004)

5. Coverage of the DOTS/TAES Strategy (by country, Americas, 2002)
>90%
>50<89%
>10<49%
<10%
No DOTS
Argentina
Belize
Chile
Cuba
El Salvador
Guatemala
Honduras
Peru
Puerto Rico
Nicaragua
Uruguay
USA
Bolivia
Costa Rica
Mexico
Panama
Venezuela
Brazil
Colombia
Dominican Republic
Ecuador
Guyana
Haiti
Paraguay
English-speaking Caribbean
Suriname
Countries in the same category without changes
Countries that have improved their coverage within the same category
Countries whose category has gone up
Status of TB Operations (Region of the Americas, 2004)

6. Success in Treating TB BAAR+ Cases (Region of the Americas, 2002)
OR= 2.21 (IC:2.15 – 2.28)
17%
83%
41%
Con esta lamina pretendemos mostrar que los pacientes manejados con DOTS/TAES, tienen 2,21 veces mayor probabilidad de curar que los no DOTS, y en términos de porcentaje el resultados de pacientes tratados con DOTS es mayor en un 24% que los no DOTS.
59%
Status of TB Operations (Region of the Americas, 2004)

7. Current Limitations for Controlling TB, Region of the Americas
Political support for National TB Programs.
Health-sector reform process.
Irregular drug supply.
High staff turnover, need to improve training (management/supervision).
Organization of laboratory network, insufficient quality control.
Inconsistent registry system and delay in reporting.
Insufficient monitoring and cohort analysis.
Estas limitaciones son generales para la región por lo que sugerimos, enfatizar en las que apliquen para su país.
Status of TB Operations (Region of the Americas, 2004)

8. Status of TB Operations (Region of the Americas, 2004)
Main Challenges
Expand DOTS Strategy in the remaining countries, so as to achieve total DOTS coverage in 2005.
Strengthen laboratory capacity.
Strengthen regional capacity for country monitoring.
Maintain and/or reinforce resistance surveillance.
Status of TB Operations (Region of the Americas, 2004)

9. Status of TB Operations (Region of the Americas, 2004)
Main Challenges
Coordinate joint strategies for HIV/AIDS-TB Programs.
Increase access to and application of strategies for groups at high risk for TB.
Minimize possible negative effects of the health-sector reform process..
Maintain high levels of training and supervision at the country level.
Status of TB Operations (Region of the Americas, 2004)

10. Millennium Development Objectives (2015)
Goal 6
Fight HIV/AIDS, Malaria, and other illnesses (TB).
Objective 8
Stop and begin to reduce the spread of HIV/AIDS.
Stop and begin to reduce the incidence of malaria and other serious illnesses (TB).
Indicators
23. Prevalence and mortality rates associated with tuberculosis.
24. Proportion of tuberculosis cases detected and cured under DOTS.
Status of TB Operations (Region of the Americas, 2004)

11. Regional Action Plan (PAHO Regional Program on TB, 2004–2005)
The Plan of Action for the biennium will be structured on the basis of the magnitude of the TB problem in the countries and the challenges for implementing/expanding the DOTS/TAES Strategy.
Objective
To assist the countries of the Region of the Americas in the implementation and expansion of the DOTS/TAES Strategy, so as to achieve millennium objectives.
Status of TB Operations (Region of the Americas, 2004)

12. Status of TB Operations (Region of the Americas, 2004)
Strategy and Goals
Strategy
Support to countries in the extension of the DOTS Strategy, via training, monitoring, and evaluation.
Support to countries for surveillance of resistance of anti-tubercular drugs (MDR).
Advocacy in the search for technical and financial partners.
Goals
For all countries of the Region to have implemented/expanded the DOTS/TAES Strategy on a national scale by the end of 2005.
Status of TB Operations (Region of the Americas, 2004)

13. Status of TB Operations (Region of the Americas, 2004)
World TB Day
24 March 2004
Status of TB Operations (Region of the Americas, 2004)