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Tuberculosis problems in the Asia-Pacific region.

A Shimouchi1

  • 1The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan. shimouchi@jata.or.jp

Respirology (Carlton, Vic.)
|March 27, 2001
PubMed
Summary

Tuberculosis (TB) remains a major killer in developing nations, particularly in Asia. Effective control requires nationwide Directly Observed Treatment, Short-course (DOTS) implementation, free anti-TB drugs, and strengthened healthcare to combat rising drug resistance.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Tuberculosis (TB) is a leading cause of mortality in productive-age populations in developing countries, with over half of global cases in the Asia-Pacific region.
  • Projected increases in TB cases are linked to urban poverty, rising HIV incidence, and inadequate healthcare access and TB programs.
  • Stagnating TB incidence in intermediate-burden Asian countries is attributed to aging populations, urban poverty health issues, and migration from high-endemic areas.

Purpose of the Study:

  • To highlight the challenges in TB control in developing countries, especially in Asia.
  • To emphasize the importance of Directly Observed Treatment, Short-course (DOTS) and its current coverage limitations.
  • To underscore the correlation between past TB control quality and current drug resistance rates.

Main Methods:

  • Analysis of TB incidence and mortality trends in developing countries, with a focus on the Asia-Pacific region.
  • Evaluation of Directly Observed Treatment, Short-course (DOTS) program coverage in different regions.
  • Examination of factors contributing to TB incidence stagnation and drug resistance.

Main Results:

  • DOTS coverage is high in the Western Pacific Region (58%) but low in Southeast Asia (29%).
  • TB incidence reduction has stalled in some Asian countries due to demographic and socioeconomic factors.
  • A strong correlation exists between historical TB control quality and current primary drug resistance rates.

Conclusions:

  • Nationwide DOTS implementation, free anti-TB drug availability, and strengthened primary healthcare are crucial for high TB-burden countries.
  • Involving general hospitals and the private sector is essential to prevent the emergence of drug-resistant TB cases.
  • Addressing urban poverty and improving healthcare access are vital components of future TB control strategies.

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