Effects of the Health Transformation Programme on tuberculosis burden in Turkey

The Fifty-ninth Turkish Government announced an emergency action plan and embarked on a comprehensive health reform named "Health Transformation Program" (HTP) in 2003. This study investigated the effects of HTP on tuberculosis (TB) burden from 2003 to 2010 in Turkey.

TB incidence, prevalence, mortality and case detection rates, treatment success and direct observed treatment strategy (DOTS) applications rate, and contribution of these applications in the success of the TB war were retrospectively investigated.

The annual decrease of incidence rate was 2.86 between 1995 and 2002, and 1.22 between and 2003 and 2010, (p < 0.05). The decrease of prevalence rate was 2.88 between 1995 and 2002 and 1.25 between 2003 and 2010 (p < 0.05). The annual declines in mortality were 0.44 between 1995 and 2002 and 0.22 between 2003 and 2010 (p < 0.005). The DOTS application rate increased from 0% in 2003 to 98% in 2010. After the HTP treatment success rate of TB at 85% of Turkey was firstly reached to 89% in 2005 and increased to 91% in 2007. Case detection rate of new pulmonary TB patients was 82% in 2005 and 81% in 2008 reaching the WHO target for the first time with HTP.

A trend of reduced TB burden began in Turkey in 1997. As a result of the implementation of HTP beginning in 2003, the target treatment success and DOTS application rates were achieved and progress has continued even in the face of the recent worldwide economic crisis.