Scale up: meeting targets in global tuberculosis control.

Area of Science:

• Public Health
• Infectious Disease Epidemiology

Background:

• Global tuberculosis (TB) control targets face challenges in achievement, particularly regarding case detection and cure rates.
• A notable gap exists between estimated incident TB cases and those reported under the Directly Observed Treatment, Short-course (DOTS) strategy.
• Delayed progress impacts TB incidence, especially in high-incidence regions like sub-Saharan Africa and the former Soviet Union.

Purpose of the Study:

• To identify critical actions needed to accelerate progress towards global tuberculosis control targets.
• To address the case-detection gap and improve the effectiveness of TB control strategies.

Main Methods:

• Analysis of the current status of global tuberculosis control efforts.
• Identification of key strategic actions required for program enhancement and expansion.

Main Results:

• Progress towards 2005 global tuberculosis targets is at risk due to a case-detection deficit.
• Four key actions are proposed to expedite TB control: strengthening national TB programs' stewardship, assessing DOTS coverage certification, fostering community involvement, and increasing support for TB/HIV co-infection in sub-Saharan Africa.

Conclusions:

• Urgent and strategic interventions are necessary to bridge the TB case-detection gap and achieve global control goals.
• Enhanced national program capacity, community participation, and targeted support are crucial for effective tuberculosis management, particularly in high-burden regions facing co-infections.