ABSTRACT
The burden of tuberculosis (TB) is now very slowly decreasing globally. However, the rate of decline is too slow to reach all the epidemiological impact targets set for 2015. The prospects for reaching the TB elimination target set for 2050 are even bleaker. Implementation of the World Health Organization's Stop TB Strategy is currently lagging behind the envisioned scale-up pace, particularly with regard to TB/HIV collaborative activities and management of drug resistant TB. To ensure long-term TB control there is, first, a need to ensure that all components of the Stop TB Strategy are scaled up according to plans, with special attention to improved access for the poor. However, this may not be enough. Recent analyses suggest that the impact of current efforts to reduce TB incidence is less than expected and that improved diagnostic and curative efforts need to be combined with additional preventive efforts. New and more effective vaccines and drugs for preventive treatment would revolutionize TB control. A stronger focus on prevention would also entail more concerted actions to limit the impact of TB risk factors, including HIV/AIDS, smoking, malnutrition, alcoholism, diabetes, crowded living conditions, and indoor air pollution, which may all contribute a considerable proportion of the global TB burden.
KEYWORDS
Tuberculosis - strategy - epidemiology - disease control - determinants
REFERENCES
-
1 WHO .Global Tuberculosis Control. WHO/HTM/TB/2008.393. Geneva; World Health Organization 2008
-
2 WHO .Forty-fourth World Health Assembly. WHA44/1991/REC/1. Geneva; WHO 1991
-
3
Raviglione M C, Pio A.
Evolution of WHO policies for tuberculosis control, 1948–2001.
Lancet.
2002;
359
775-780
-
4 WHO .WHO Tuberculosis Programme—Framework for Effective Tuberculosis Control. WHO/TB/94.179. Geneva; World Health Organization 1994
-
5 World Bank .World Development Report 1993—Investing in Health. Washington; World Bank 1993
-
6 Dye C, Floyd K. Tuberculosis. In: Jamison T, Breman JG, Measham AR, et al Disease Control Priorities in Developing Countries. Washington, DC; World Bank 2006: 289-309
-
7 Laxminarayan R, Klein E, Dye C et al.. Economic Benefit of Tuberculosis Control. Policy Research Working Paper 4295. Washington; World Bank 2007
-
8
Raviglione M C, Uplekar M.
WHO's new Stop TB Strategy of WHO.
Lancet.
2006;
367
952-955
-
9 WHO .The Stop TB Strategy: Building on and Enhancing DOTS to Meet the TB-Related Millennium Development Goals. WHO/HTM/TB2006.368. Geneva; World Health Organization 2006a
-
10 Stop TB Partnership .The Global Plan to Stop TB 2006–2015. WHO/HTM/STB/2006.35. Geneva; World Health Organization 2006
-
11
Maher D, Dye C, Floyd K et al..
Planning to improve global health: the next decade of tuberculosis control.
Bull World Health Organ.
2007;
85
341-347
-
12
Matiru R, Ryan T.
The Global Drug Facility: a unique, holistic and pioneering approach to drug procurement and management.
Bull World Health Organ.
2007;
85
348-353
-
13
Gupta R, Cegielski J P, Espinal M A et al..
Increasing transparency in partnerships for health: introducing the Green Light Committee.
Trop Med Int Health.
2002;
7
970-976
-
14 Styblo K, Bumgarner J R. Tuberculosis Can Be Controlled with Existing Technologies: Evidence. The Hague; Tuberculosis Surveillance Research Unit 1991
-
15
Dye C, Garnett G P, Sleeman K, Williams B G.
Prospects for worldwide tuberculosis control under the WHO DOTS strategy: directly observed short-course therapy.
Lancet.
1998;
352
1886-1891
-
16
Borgdorff M W, Floyd K, Broekmans J F.
Interventions to reduce tuberculosis mortality and transmission in low- and middle-income countries.
Bull World Health Organ.
2002;
80
217-227
-
17
Corbett E L, Watt C J, Walker N et al..
The growing burden of tuberculosis: global trends and interactions with the HIV epidemic.
Arch Intern Med.
2003;
163
1009-1021
-
18
Shilova M V, Dye C.
The resurgence of tuberculosis in Russia.
Philos Trans R Soc Lond B Biol Sci.
2001;
356
1069-1075
-
19
Walberg P, McKee M, Shkolnikov V, Chenet L, Leon D A.
Economic change, crime, and mortality crisis in Russia: regional analysis.
BMJ.
1998;
317
312-318
-
20
Leon D A, Chenet L, Shkolnikov V M et al..
Huge variation in Russian mortality rates 1984–94: artefact, alcohol, or what?.
Lancet.
1997;
350
383-388
-
21
Dye C, Williams B G.
Eliminating human tuberculosis in the twenty-first century.
J R Soc Interface.
2008;
5
653-662
-
22
Suarez P G, Watt C J, Alarcon E et al..
The dynamics of tuberculosis in response to 10 years of intensive control effort in Peru.
J Infect Dis.
2001;
184
473-478
-
23
Gonzalez E, Armas L, Llanes M J.
Progress towards tuberculosis elimination in Cuba.
Int J Tuberc Lung Dis.
2007;
11
405-411
-
24
China Tuberculosis Control Collaboration .
The effect of tuberculosis control in China.
Lancet.
2004;
364
417-422
-
25
Subramani R, Santha T, Frieden T R et al..
Active community surveillance of the impact of different tuberculosis control measures, Tiruvallur, South India, 1968–2001.
Int J Epidemiol.
2007;
36
387-393
-
26
Zuniga M, Rojas M.
Programa nacional de control de la tuberculosis ano 2000: avances hacia la eliminacion.
Rev Chil Enf Respir.
2002;
18
55-63
-
27 Rodriguez De Marco J, Sanches D, Alvarez T, Goya E L. Control de la tuberculosis en Uruguay: 25 anos de la implantacion del programa nacional de control de la tuberculosis. Washington; Pan American Health Organization 2007
-
28
Huong N T, Duong B D, Co N V et al..
Tuberculosis epidemiology in six provinces of Vietnam after the introduction of the DOTS strategy.
Int J Tuberc Lung Dis.
2006;
10
963-969
-
29
Vree M, Duong B D, Sy D N, Co N V, Borgdorff M W, Cobelens F GJ.
Tuberculosis trends, Vietnam.
Emerg Infect Dis.
2007;
13
796-797
-
30
Dye C, Ottmani S, Laasri L, Bencheikh N.
The decline of tuberculosis epidemics under chemotherapy: a case study in Morocco.
Int J Tuberc Lung Dis.
2007;
11
1225-1231
-
31 Watt C, Hosseini M, Lonnroth K, Williams B, Due C. The global epidemiology of tuberculosis. In: Schaaf H, Zumla A Tuberculosis. London; Global Medicine–Elsevier In press
-
32
Borgdorff M W.
New measurable indicator for tuberculosis case detection.
Emerg Infect Dis.
2004;
10
1523-1528
-
33
van Leth F, van der Werf M J, Borgdorff M W.
Prevalence of tuberculous infection and incidence of tuberculosis: a reassessment of the Styblo rule.
Bull World Health Organ.
2008;
86
20-26
-
34 Porter JDH, Grange JM Tuberculosis: An Interdisciplinary Perspective. London; Imperial College Press 1999
-
35
Storla D G, Yimer S, Bjune G A.
A systematic review of delay in the diagnosis and treatment of tuberculosis.
BMC Public Health.
2008;
8
15
, [Epub ahead of print]
-
36
European Concerted Action on New Generation Genetic Markers and Techniques for the Epidemiology and Control of Tuberculosis .
Beijing/W genotype Mycobacterium tuberculosis and drug resistance.
Emerg Infect Dis.
2006;
12
736-743
-
37
Hanekom M, van der Spuy G D, Streicher E et al..
A recently evolved sublineage of the Mycobacterium tuberculosis Beijing strain family is associated with an increased ability to spread and cause disease.
J Clin Microbiol.
2007;
45
1483-1490
-
38
Cox H S, Morrow M, Deutschmann P W.
Long-term efficacy of DOTS regimens for tuberculosis: systematic review.
BMJ.
2008;
336
484-487
-
39
McKeown T, Record R G.
Reasons for the decline of mortality in England and Wales during the nineteenth century.
Popul Stud (Cam).
1962;
16
94-122
-
40
Lienhardt C.
From exposure to disease: the role of environmental factors in susceptibility to and development of tuberculosis.
Epidemiol Rev.
2001;
23
288-301
-
41
Soemantri S, Senewe F P, Candrarini D et al..
Three-fold reduction in the prevalence of tuberculosis over 25 years in Indonesia.
Int J Tuberc Lung Dis.
2007;
11
398-404
-
42
Irawati S R, Basri C, Arias M S et al..
Hospital DOTS linkage in Indonesia: a model for DOTS expansion into government and private hospitals.
Int J Tuberc Lung Dis.
2007;
11
33-39
-
43
Al-Maniri A, Al-Rawas O, Al-Tuhami H, Eriksson B, Diwan V K.
Towards the elimination of tuberculosis in a developing country: 25 years of tuberculosis control in Oman.
Int J Tuberc Lung Dis.
2007;
11
175-180
-
44 Rieder H. Epidemiologic Basis of Tuberculosis Control. Paris; International Union Against Tuberculosis and Lung Disease 1999
-
45
Menzies D, Joshi R, Pai M.
Risk of tuberculosis infection and disease associated with work in health care settings.
Int J Tuberc Lung Dis.
2007;
11
593-605
-
46
Cegielski J P, McMurray D N.
The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals.
Int J Tuberc Lung Dis.
2004;
8
286-298
-
47
Lin H, Ezzati M, Murray M.
Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis.
PLoS Med.
2007;
4
e142
-
48
Slama K, Chiang C Y, Enarson D et al..
Tobacco and tuberculosis: a qualitative systematic review and meta analysis.
Int J Tuberc Lung Dis.
2007;
11
1049-1061
-
49 Rehfuess E. Fuel for Life: Household Energy and Health. Geneva; World Health Organization 2006
-
50
Lönnroth K, Williams B G, Stadlin S, Jaramillo E, Dye C, Raviglione M.
Alcohol use as risk factor for tuberculosis disease: a systematic review.
BMC Public Health.
2008;
8
289
-
51
Stevenson C R, Critchley J A, Forouhi N G et al..
Diabetes and the risk of tuberculosis: a neglected threat to public health?.
Chronic Illn.
2007;
3
228-245
-
52
Prince M, Patel V, Saxena S et al..
No health without mental health.
Lancet.
2007;
370
859-877
-
53 WHO .Global Tuberculosis Control. WHO/HTM/TB/2005.349. Geneva; World Health Organization 2005
-
54 UNAIDS and WHO .2006 AIDS Epidemic Update: Special Report on HIV/AIDS. December 2006 Geneva; UNAIDS
-
55 FAO .The State of Food Insecurity in the World 2006. Rome; Food and Agriculture Organization of the United Nations 2006
-
56 International Diabetes Federation .Diabetes Atlas, 2006. http://www.eatlas.idf.org Accessed March 2007
-
57 Mackay J, Eriksen M, Shafey O. The Tobacco Atlas. Atlanta; American Cancer Society 2006
-
58
Stevenson C R, Forouhi N G, Roglic G et al..
Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence.
BMC Public Health.
2007;
7
234
, [Epub ahead of print]
-
59 Hassmiller K. The Impact of Smoking on Population Level Tuberculosis Outcomes. TSRU progress report 2007. The Hague; KNCV 2007
-
60 WHO .Reaching the Poor: Challenges for TB Programmes in the Western Pacific Region. WHO/HTM/TB/2005.352. Manila; World Health Organization 2004
-
61 Hanson C, Floyd K, Weil D. Tuberculosis in the poverty alleviation agenda. In: Raviglione M TB: A Comprehensive International Approach. New York; Informa Healthcare 2006: 1097-1114
-
62
Harling G, Rodney E, Myer L.
The social epidemiology of tuberculosis in South Africa: a multilevel analysis.
Soc Sci Med.
2008;
66
492-505
-
63
Muniyandi M, Ramachandran R, Gopi P G et al..
The prevalence of tuberculosis in different economic strata: a community survey from South India.
Int J Tuberc Lung Dis.
2007;
11
1042-1045
-
64 WHO and IUATLD .A WHO / The Union Monograph on TB and Tobacco Control. WHO/HTM/TB/2007.390. Geneva; World Health Organization 2007
-
65 WHO .Commission on Social Determinants of Health. WHO/EIP/EQH/01/2006. Geneva; World Health Organization 2006
Knut LönnrothPh.D. M.D.
Stop TB Department, World Health Organization, 20 Avenue Appia
CH-1211 Geneva, Switzerland
Email: lonnrothk@who.int
