Expanding antiretroviral therapy in Malawi: drawing on the country's experience with tuberculosis

The DOTS (“directly observed treatment, short course”) strategy has been successfully used in developing countries to provide effective control of tuberculosis. Field workers in Malawi are promoting the same approach for HIV infection through the expansion of highly active antiretroviral therapy

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Bibliographic Details
Published inBMJ Vol. 329; no. 7475; pp. 1163 - 1166
Main Authors Harries, Anthony D, Libamba, Edwin, Schouten, Erik J, Mwansambo, Andrina, Salaniponi, Felix M, Mpazanje, Rex
Format Journal Article
LanguageEnglish
Published London British Medical Journal Publishing Group 13.11.2004
British Medical Association
BMJ Publishing Group LTD
BMJ Publishing Group
BMJ Publishing Group Ltd
EditionInternational edition
Subjects
Acquired immune deficiency syndrome
AIDS
Antiretroviral drugs
Antiretroviral Therapy, Highly Active
Antiretrovirals
Antituberculars
Antivirals
Bacterial diseases
Biological and medical sciences
Communicable Disease Control - methods
Developed countries
Developing countries
Directly Observed Therapy
Disease Notification
Disease Outbreaks
Drug resistance
Education And Debate
Epidemics
General aspects
Highly active antiretroviral therapy
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
Human bacterial diseases
Human immunodeficiency virus
Human resources
Human viral diseases
Humans
Infectious diseases
LDCs
Lung diseases
Malawi - epidemiology
Medical sciences
Medical treatment
Tuberculosis
Tuberculosis and atypical mycobacterial infections
Tuberculosis control
Tuberculosis, Multidrug-Resistant - epidemiology
Tuberculosis, Multidrug-Resistant - prevention & control
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Malawi
Africa
Infection
Medicine
Chemotherapy
Treatment
Tuberculosis
Countries
Viral disease
Bacteriosis
Antiviral
AIDS
Mycobacterial infection
Immune deficiency
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Summary:The DOTS (“directly observed treatment, short course”) strategy has been successfully used in developing countries to provide effective control of tuberculosis. Field workers in Malawi are promoting the same approach for HIV infection through the expansion of highly active antiretroviral therapy
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Correspondence to: A D Harries
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Funding: ADH is supported by Family Health International, and EJS is supported by Management Sciences for Health. The national expansion of HAART will be funded mainly through the Global Fund to fight AIDS, Tuberculosis and Malaria.
A box of the five components of the DOTS strategy and a patient record chart for monitoring antiretroviral therapy are on bmj.com
Correspondence to: A D Harries adharries@malawi.net
Contributors and sources: All the authors have worked with several other partners on producing the national antiretroviral treatment guidelines and the national antiretroviral expansion plan, which they are now implementing. This article is based on the authors' collective country based experience and is supplemented by published, peer reviewed research on tuberculosis and antiretroviral therapy. Simon Makombe is an antiretroviral therapy officer in Malawi who has contributed considerably to the implemenation of the expansion programme.
Competing interests: None declared.
ISSN:0959-8138
0959-8146
1468-5833
1756-1833
DOI:10.1136/bmj.329.7475.1163