Servicios de Salud locales, distritales, regionales y Unidades de salud de la Familia
                                                            
                         
                     
                                                        
                        
                        
                            
                            
                                                                    The International Journal of Tuberculosis and Lung Disease 21(5)     DOI: 10.5588/ijtld.16.0518
                                                            
                         
                     
                                                        
                        
                        
                            
                            
                                                                Research Article
BMC Infectious Diseases 2012, 12:262; doi:10.1186/1471-2334-12-262
                                                            
                         
                     
                                                        
                        
                        
                            
                            
                                                                This guidance is intended for use in developing standalone TB strategic plans, or TB interventions as part of multidisease or health sector plans. It describes key considerations and steps for strategic planning for TB in line with the World Health Organization’s End TB strategy, and the proposed ...structure of the NSP. The target audience of this publication are all stakeholders involved in national strategic planning for TB (e.g., ministry of health, other government ministries, private sector, civil society, affected communities, academic and research institutions, and technical and funding partners).
The current document is an update to the 2015 Toolkit to develop a national strategic plan for TB prevention, care and control.
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                                                                2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and th...ey have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced  GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment  of  TB  in  children  has  been  reviewed  and  now  includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately  dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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                                                                Non-Communicable   Diseases   (NCDs)   are   a   worldwide   epidemic.   Particularly,  the  most  common  diseases  -   Cardiovascular  diseases,  Chronic   Obstructive   Pulmonary   Diseases   (COPD),   Chronic   Kidney Diseases, Cancer,  Diabetes,  injuries  and  disabilities,  EMT, oral,  eye  g...reatly  contribute  to  the  morbidity  and  mortality  accounting  for  around  60%  of  all  deaths  worldwide.  The  disease  pattern  is  also  changing  from  infectious  to  chronic  in  Rwanda  like  other  developing  countries   due   to   the   epidemiological   transition.
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