Did we reach the 2005 targets for tuberculosis control?

Abstract

TB incidence rates are rarely measured directly in longitudinal studies; therefore, incidence is estimated from population-based, cross-sectional surveys of the prevalence of Mycobacterium tuberculosis infection or TB disease, or from independent assessments (often qualitative) of the performance of surveillance systems. 13,14 The essential formulae for calculating incidence are:The available data differ from country to country, and not all methods can be applied in every country; in particular, Abstract The World Health Assembly set targets to detect by 2005 at least 70% of all new sputum smear-positive cases arising each year and to cure at least 85% of these cases. The national tuberculosis (TB) control programmes of 199 countries reported that in 2005, 2.3 million new smear-positive cases were diagnosed under WHO's DOTS strategy, out of an estimated 3.9 million (95% confidence limit (CL) 3.4 million to 4.4 million) new smear-positive cases arising in that year, a global case detection rate of 60% (95% CL 52% to 69%). Of 2.1 million new smear-positive patients registered for treatment in 2004, 84% had successful outcomes. Of the regions, only the WHO Western Pacific Region reached both targets, with case detection and treatment success rates of 76% and 91%, respectively; South-East Asia reached the treatment success target with a rate of 87%. In relation to countries, WHO estimates that 67 achieved the target detection rates and 57 achieved the target for treatment success, with 26 -including high-burden countries China, the Philippines and Viet Nam -achieving both targets. DOTS programmes diagnosed more than 26 million patients (all forms of TB) in 1995-2005. Building on this success, the Global Plan to Stop TB 2006-2015, describes the actions needed to implement WHO's new Stop TB Strategy over the coming decade to reduce TB incidence, prevalence and deaths in line with the Millennium Development Goals.

Lives saved by tuberculosis control and prospects for achieving the 2015 global target for reducing tuberculosis mortality

“…Measurements of illness duration during national surveys of the prevalence of TB disease do not represent the duration distribution throughout the country because survey investigations shorten the national history of disease in previously undetected prevalent cases. In this study we used incidence estimates published by WHO 4 and accounted for the uncertainty in incidence estimates when deriving indirect mortality estimates.…”

“…The rate of treatment success among notified cases of smear-positive TB increased from 57% in 1995 to 86% in 2008. 4 More recently, attention has shifted to measuring progress towards achievement of global targets for reductions in disease burden (Box 1). The global target under the Millennium Development Goals (MDGs) is that TB incidence should be declining by 2015.…”

“…The Stop TB Partnership has endorsed this MDG target and has also set two additional global targets, namely, to halve TB prevalence and mortality rates by 2015 compared with their level in 1990. 4 Methods for measuring trends in disease burden have been clearly described 5,6 and recommendations set out in a WHO policy paper. 7 In addition to assessing trends in disease burden, it has become increasingly important to determine the number of lives saved by health-care interventions and the contribution of disease control efforts to the broader goal of improving maternal and child health (MDGs 4 and 5, Box 1).…”

Evaluation of Borama tuberculosis control program in Somaliland, Somalia

“…The increase in the success rate could also be caused by the continued elder involvement in the treatment initiation and completion. This measure, which is an indicator monitored by national TB programs, affirms that the TB programs in Borama and Hargeisa met the required benchmark for treatment completion of new TB patients in the post-event period [1,11,12].…”

“…These are standard measures that national TB control programs record in TB registries and monitor, according to the WHO [12]. The pre-event (2002)(2003) and post-event measures (2007) within each program and between Borama and Hargeisa TB programs were compared.…”