An analysis of a decade-long tuberculosis (TB) programme in China has revealed that prevalence rates of the disease have fallen substantially since the introduction of the TB control strategy known as 'DOTS' to half of the country's population.
The results not only demonstrate the effectiveness of DOTS, but also provide a powerful argument for the need to expand the strategy across the entire country.
Today, the Chinese TB Control Collaboration, which includes the Ministry of Health of China and the World Health Organization, published a report in The Lancet on the impact of the World Bank funded project. The project was initiated in 1991, one year after a national TB survey, and introduced DOTS to half the Chinese population.
A repeat survey, carried out ten years later in 2000, provided the opportunity to assess the health benefits of DOTS. The report's authors concluded that prevalence of TB fell by an estimated 30%, or 382 000 cases, as a result of the DOTS project - a substantial decline.
Still, there are major challenges that must be met if China is to reach the United Nations Millennium Development Goal (MDG) of halving TB prevalence by 2015. TB remains a significant public health problem in China. With 1.4 million new cases a year, China is second only to India when it comes to incidence of the disease. Given the proven success of DOTS so far it is important that the strategy be further expanded across the country.
"By building on the successes of the past decade, and by providing all of its more than one billion people with access to high-quality treatment, China could make a major contribution to the global control of tuberculosis," said Dr Christopher Dye, WHO's lead investigator in the recent analysis.