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Can tuberculosis be controlled?
1Regional Office for South-East Asia, World Health Organization, New Delhi, India. tfrieden@health.nyc.gov
International Journal of Epidemiology
|November 19, 2002
Summary
Tuberculosis (TB) is highly curable and controllable with effective public health strategies. Implementing appropriate policies and coordinated efforts can significantly reduce TB mortality, prevalence, and incidence, even in developing nations.
Area of Science:
- Public Health
- Infectious Disease Control
- Epidemiology
Background:
- Tuberculosis (TB) is a curable disease, yet its control, especially in developing countries, faces skepticism.
- Doubts persist regarding the efficacy of medical and public health interventions in managing TB globally.
Purpose of the Study:
- To evaluate the amenability of tuberculosis to control through medical and public health interventions.
- To analyze the potential for reducing TB deaths, prevalence, infection rates, and incidence.
Main Methods:
- Review of existing data on tuberculosis control.
- Separate analysis of control strategies for mortality, prevalence, infection rate, and incidence.
Main Results:
- Tuberculosis mortality can be reduced by over 80% within 5 years.
- Annual TB prevalence can decrease by over 30%, with documented 17% annual reductions in developing countries.
- TB infection rates can be reduced by 15% annually, and incidence by up to 25% annually (10% in developing countries), though HIV co-infection complicates control.
Conclusions:
- Effective TB control is achievable through appropriate policies, robust clinical and public health management, and coordinated multi-sectoral efforts.
- The human immunodeficiency virus (HIV) pandemic significantly increases TB incidence, necessitating integrated control strategies.
- Less than 30% of global TB cases received effective diagnosis, treatment, and monitoring by 2001, highlighting the urgent need for expanded TB control services.