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Free Content Rapid decline in prevalence of pulmonary tuberculosis after DOTS implementation in a rural area of South India

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SETTING: Tiruvallur District in Tamilnadu, South India, where the World Health Organization-recommended DOTS strategy was implemented as a tuberculosis (TB) control measure in 1999.

OBJECTIVE: To assess the epidemiological impact of the DOTS strategy on the prevalence of pulmonary tuberculosis (PTB).

DESIGN: Surveys of PTB were undertaken on representative population samples aged ≥15 years (n = 83 000–90 000), before and at 2.5 and 5 years after the implementation of the DOTS strategy. The prevalence of PTB (smear-positive/culture-positive) was estimated.

RESULTS: TB prevalence declined by about 50% in 5years, from 609 to 311 per 100 000 population for culture-positive TB and from 326 to 169/100 000 for smear-positive TB. The annual rate of decline was 12.6% (95%CI 11.2–14.0) for culture-positive TB and 12.3% (95%CI 8.6–15.8) for smear-positive TB. The decline was similar at all ages and for both sexes.

CONCLUSION: With an efficient case detection programme and the DOTS strategy, it is feasible to bring about a substantial reduction in the burden of TB in the community.
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Keywords: DOTS; community survey; epidemiology; prevalence; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Tuberculosis Research Centre, Chennai, India 2: Institute for Research in Medical Statistics, Madras Chapter (ICMR), Chennai, India 3: Department of Health and Mental Hygiene, New York, New York, USA 4: Office of the World Health Organization Representative to India, New Delhi, India

Publication date: August 1, 2008

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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