SETTING: One baseline and three repeat surveys of the prevalence of tuberculosis (TB) disease were conducted in 1999-2008 in rural South India, where the DOTS strategy was implemented in 1999. The impact of DOTS on prevalence was documented, but not its impact on incidence. OBJECTIVE: To ascertain epidemiological trends in the incidence of smear-positive TB. DESIGN: All persons aged ⩾15 years (range 83 000-92 000) were examined using chest radiography (CXR); chest symptoms and history of anti-tuberculosis chemotherapy were noted in all four surveys. Sputum was collected from eligible participants and tested using direct smear and culture, and for drug susceptibility. As follow-up surveys were not frequent, survey cases and cases directly notified under DOTS were combined to estimate the incidence of smear-positive TB. RESULTS: Coverage was consistently high in all the repeat surveys, at ⩾80% for CXR and symptom recording, and at ⩾95% for sputum examination. The annual incidence of smear-positive TB was respectively 112, 80 and 76 per 100 000 population in 2001-2003, 2004-2006 and 2006-2008. The overall decline observed was 7.5% per annum. CONCLUSION: A well-implemented DOTS strategy can lead to a reduction in the TB burden in the community.
SETTING: One baseline and three repeat surveys of the prevalence of tuberculosis (TB) disease were conducted in 1999-2008 in rural South India, where the DOTS strategy was implemented in 1999. The impact of DOTS on prevalence was documented, but not its impact on incidence. OBJECTIVE: To ascertain epidemiological trends in the incidence of smear-positive TB. DESIGN: All persons aged ⩾15 years (range 83 000-92 000) were examined using chest radiography (CXR); chest symptoms and history of anti-tuberculosis chemotherapy were noted in all four surveys. Sputum was collected from eligible participants and tested using direct smear and culture, and for drug susceptibility. As follow-up surveys were not frequent, survey cases and cases directly notified under DOTS were combined to estimate the incidence of smear-positive TB. RESULTS: Coverage was consistently high in all the repeat surveys, at ⩾80% for CXR and symptom recording, and at ⩾95% for sputum examination. The annual incidence of smear-positive TB was respectively 112, 80 and 76 per 100 000 population in 2001-2003, 2004-2006 and 2006-2008. The overall decline observed was 7.5% per annum. CONCLUSION: A well-implemented DOTS strategy can lead to a reduction in the TB burden in the community.
Authors: Abolfazl Marvi; Mehran Asadi-Aliabadi; Mehdi Darabi; Fereshteh Rostami-Maskopaee; Hasan Siamian; Ghasem Abedi Journal: J Family Med Prim Care Date: 2017 Oct-Dec