Trends in the prevalence of pulmonary tuberculosis over a period of seven and half years in a rural community in south India with DOTS.

Kolappan, C and Subramani, R and Radhakrishna, S and Santha, T and Wares, F and Baskaran, D and Selvakumar, N and Narayanan, P R (2013) Trends in the prevalence of pulmonary tuberculosis over a period of seven and half years in a rural community in south India with DOTS. The Indian journal of tuberculosis, 60 (3). pp. 168-76. ISSN 0019-5707

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Abstract

SETTING Tiruvallur district In Tamil Nadu where DOTS was implemented by the State Government as the tuberculosis control measure in 1999, and monitored by the National Institute for Research in Tuberculosis for over five years. OBJECTIVE To estimate trends in TB prevalence in a rural community with DOTS. DESIGN Surveys of pulmonary tuberculosis were undertaken in representative samples of subjects aged > or =15 years (N = 83,000 - 92,000), initially and after two and half, five and seven and half years of implementation of DOTS. Sputa were collected from those with abnormal radiograph and/or presence of chest symptoms, and examined by direct smear and culture. RESULTS The prevalence of culture-positive tuberculosis was 607, 454, 309 and 388 per 100,000 in the four surveys, and that of smear-positive tuberculosis was 326, 259, 168 and 180. In the first five years; annual decrease was 12.4% (95% CI 10.4 - 14.4%) for culture-positive tuberculosis, and 12.2% (95% CI 8.0-16.2) for smear-positive tuberculosis. This was, however, followed by a significant increase in the next two and half years. The average new smear-positive case-notification rate was 75 per 100,000 during first four years but declined to 49 in subsequent years. There were no methodological differences during this period and information on changes in socio-economic indicators and nutritional standards was unavailable. CONCLUSION Despite the average annual success rate (78%) in this tuberculosis unit being lower than the expected rate of 85%, the implementation of DOTS was followed by a substantial decrease in the prevalence of pulmonary tuberculosis over the seven and half year period. Our findings suggest that sustaining the high effectiveness of DOTS programme needs vigilant supervision.

Affiliation:	ICMR-National Institute for Research in Tuberculosis
Item Type:	Article
Uncontrolled Keywords:	prevalence, pulmonary tuberculosis, seven and half years, RURAL community, south India, DOTS
Subjects:	Tuberculosis > Epidemiological Research
Divisions:	Epidemiology
Depositing User:	Dr. Rathinasabapati R
Date Deposited:	20 Sep 2022 10:47
Last Modified:	20 Sep 2022 10:47
URI:	http://eprints.nirt.res.in/id/eprint/1241

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