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Free Content Significant decline in the tuberculosis burden in the Philippines ten years after initiating DOTS

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BACKGROUND: The Philippines ranks ninth among the 22 high-burden countries for tuberculosis (TB).

OBJECTIVE: To measure the burden of pulmonary tuberculosis (PTB) in the Philippines and determine the impact of the DOTS strategy.

MATERIALS AND METHODS: The 2007 nationwide TB prevalence survey covered 50 clusters selected by multi-stage stratified random sampling from Metro Manila and other urban and rural areas. Subjects aged ≥10 years were screened radiographically for PTB to identify subjects for sputum examination and determine the prevalence of bacteriologically confirmed PTB, i.e., smear- and/or culture-positive PTB.

RESULTS: In subjects aged ≥10 years, the 2007 prevalence of radiographic PTB was 6.3% (95%CI 5.5–7.1), bacteriologically confirmed PTB was 6.6 per 1000 (95%CI 5.1–8.1) and sputum smear-positive PTB was 2.6/1000 (95%CI 1.7–3.6). For the total population, the corresponding estimates were respectively 4.7%, 4.9/1000 and 2.0/1000. Between 1997 and 2007, there was a 31% reduction in bacteriologically confirmed PTB (P < 0.02) and a 27% reduction in smear-positive PTB (P = 0.18). This decline occurred despite the increasing poverty in the population.

CONCLUSION: The survey demonstrated a significant decline in the TB burden 10 years after the implementation of DOTS, facilitated by a strategic public-private partnership.

Keywords: DOTS; Philippines; prevalence survey; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Tropical Disease Foundation, Makati, The Philippines 2: World Health Organization Consultant, Hyderabad, India 3: Department of Radiology, Makati Medical Center, Makati, The Philippines 4: Department of Health, Manila, The Philippines

Publication date: 2009-10-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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