TB Control Program in China Linked to Drop in Prevalence
During 1990s, smear-positive prevalence decreased only in provinces with the DOTS program
TUESDAY, March 18, 2014 (HealthDay News) -- The implementation of a tuberculosis control program in China was associated with a reduction in prevalence and increased treatment, according to a study published online March 18 in The Lancet.
Lixia Wang, from the Chinese Center for Disease Control and Prevention in Beijing, and colleagues assessed the effect of a tuberculosis control program (based on the directly observed treatment, short course [DOTS] strategy). Data were compared from three national tuberculosis prevalence surveys conducted in 1990, 2000, and 2010. The 2010 survey included 252,940 eligible individuals (aged 15 years and older) chosen by stratified random sampling.
The researchers found that the prevalence of smear-positive tuberculosis decreased from 170 to 59 cases per 100,000 population from 1990 to 2010. Smear-positive prevalence decreased only in provinces with the DOTS program during the 1990s; prevalence decreased in all provinces after 2000. Of the total reduction in smear-positive prevalence, 70 percent occurred after 2000. The proportion of known cases treated by the public health system (using the DOTS strategy) increased from 15 percent in 2000 to 66 percent in 2010, contributing to a significant decrease in the proportion of treatment default and retreatment cases.
"Marked improvement in tuberculosis treatment, driven by a major shift in treatment from hospitals to the public health centers (that implemented the DOTS strategy) was largely responsible for this epidemiological effect," the authors write.