Now that progress is gradually being made in the implementation of the DOTS strategy in
low-income countries, we must take into account the fact that nearly 30% of all tuberculosis
(TB) cases worldwide occur in middle-income countries, which usually have an adequate
health infrastructure and sufficient economic resources for TB control. These countries
nevertheless have other limitations that make it necessary to develop other aspects in
addition to the DOTS strategy. These can be summarised in three main themes: 1) adequate …

In the first of these two articles it was expressed how, in practically all middle-income and
many low-income countries, it is necessary to implement interventions in addition to the
DOTS strategy if adequate tuberculosis control is to be achieved. We need to act in two
directions: 1) in universities and medical schools, as explained in the first article, and 2)
specifically among private physicians and medical specialists, an important obstacle for
many National Tuberculosis Programmes (NTPs). These professionals, especially medical …