BACKGROUND: Tuberculosis (TB) case notifications per capita fell by only 3-4% per year in Morocco between 1996 and 2005, despite implementation of the World Health Organization (WHO) DOTS strategy since the early 1990s. At the current pace of epidemic decline, there will be more than 10,000 new cases in 2050, the target year for global elimination. METHODS: Analysis of cases reported by the National TB Control Programme, disaggregated by age, sex, clinical form of TB and region, for years 1996-2005. The validity of observed patterns was judged using four criteria: statistical validity, precision of measurement, biological plausibility and the consistency and strength of different lines of evidence. RESULTS: TB incidence (case numbers and rates) is higher in urban than in rural areas and higher in adult men than in women. The most infectious (smear-positive) form of the disease is more frequent in men with TB than women. Men aged 15-44 years accounted for half of all smear-positive cases in 2005. TB incidence has fallen more slowly than average among men, but the decline was also unexpectedly slow among women. CONCLUSIONS: In Morocco, men living in cities should be a focus for prevention and control. Globally, routine surveillance data should be more fully exploited to guide TB control activities.
BACKGROUND:Tuberculosis (TB) case notifications per capita fell by only 3-4% per year in Morocco between 1996 and 2005, despite implementation of the World Health Organization (WHO) DOTS strategy since the early 1990s. At the current pace of epidemic decline, there will be more than 10,000 new cases in 2050, the target year for global elimination. METHODS: Analysis of cases reported by the National TB Control Programme, disaggregated by age, sex, clinical form of TB and region, for years 1996-2005. The validity of observed patterns was judged using four criteria: statistical validity, precision of measurement, biological plausibility and the consistency and strength of different lines of evidence. RESULTS: TB incidence (case numbers and rates) is higher in urban than in rural areas and higher in adult men than in women. The most infectious (smear-positive) form of the disease is more frequent in men with TB than women. Men aged 15-44 years accounted for half of all smear-positive cases in 2005. TB incidence has fallen more slowly than average among men, but the decline was also unexpectedly slow among women. CONCLUSIONS: In Morocco, men living in cities should be a focus for prevention and control. Globally, routine surveillance data should be more fully exploited to guide TB control activities.
Authors: Philippe Glaziou; Katherine Floyd; Eline L Korenromp; Charalambos Sismanidis; Ana L Bierrenbach; Brian G Williams; Rifat Atun; Mario Raviglione Journal: Bull World Health Organ Date: 2011-05-31 Impact factor: 9.408
Authors: Philippe Glaziou; Charalambos Sismanidis; Katherine Floyd; Mario Raviglione Journal: Cold Spring Harb Perspect Med Date: 2014-10-30 Impact factor: 6.915
Authors: Delia Boccia; James Hargreaves; Bianca Lucia De Stavola; Katherine Fielding; Ab Schaap; Peter Godfrey-Faussett; Helen Ayles Journal: PLoS One Date: 2011-06-17 Impact factor: 3.240