Prospects for worldwide tuberculosis control under the WHO DOTS strategy

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  • The fall in tuberculosis incidence under DOTS is greater in younger populations than in older ones.
  • Non-curative treatment can prevent death without eliminating infectiousness.
  • In countries where tuberculosis incidence is stable and HIV-1 is absent:
    • A control program reaching WHO targets (70% case detection, 85% cure) would reduce the incidence rate by 11% per year (range 8–12%).
    • It would reduce the death rate by 12% per year (range 9–13%).
  • If tuberculosis has been in decline for several years, the same case detection and cure rates would have a smaller effect on incidence.
  • DOTS saves a greater proportion of deaths than cases, with a larger difference in the presence of HIV-1.
  • HIV-1 epidemics increase tuberculosis incidence but do not significantly reduce the preventable proportion of cases and deaths.

    • Dye, C., Garnett, G.P., Sleeman, K. and Williams, B.G., 1998. Prospects for worldwide tuberculosis control under the WHO DOTS strategy. The Lancet, 352(9144), pp.1886-1891.

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