Goals for TB control reachable for mos...( strialized countries Latin America So...),Health

Many countries began using DOTS and other TB control programs in the 1990s. The researchers found that the number of new TB cases increased globally in 2003 by about 1 percent, although new cases, total cases, and death rates were approximately stable or decreased in seven of the nine regions. The exceptions were regions of Africa with low (less than 4 percent in adults 15-49 years) and high rates (4 percent or greater) of HIV infection. Detection of new smear-positive cases by DOTS programs increased from 11 percent in 1995 to 45 percent in 2003 (with the lowest case-detection rates in Eastern Europe and the highest rates in the Western Pacific) and could reach 60 percent by 2005. More than 17 million patients were treated in DOTS programs between 1994 and 2003, with overall treatment success rates more than 80 percent since 1998. The overall treatment success rate was 82 percent in 2003, with variation among regions. The highest rates were reported in the Western Pacific region at 89 percent, with the lowest rates in African countries with high and low HIV infection rates (71 percent and 74 percent, respectively), in industrialized countries (77 percent), and in Eastern Europe (75 percent).

To halve the prevalence rate by 2015, TB control programs must reach global targets for detection (70 percent) and treatment success (85 percent) and also reduce the incidence rate by at least 2 percent annually. To halve the death rate, incidence must decrease more steeply, by at least 5 percent to 6 percent annually, the researchers write.

"Although the global incidence rate of TB was, in our assessment, still increasing slowly in 2003 (about 1 percent per year), this increase could be reversed by further reductions in transmission in high-burden countries," the authors write.

They add that the difficulties of managing TB in Africa and Eastern Europe are closely linked t
'"/>

Contact: Christopher Dye, D.Phil.
dyec@who.int
JAMA and Archives Journals
7-Jun-2005