Epidemiology of tuberculosis in the Americas: the Stop TB strategy and the millennium development goals.

ABSTRACT

BACKGROUND: Tuberculosis (TB), a preventable and curable disease, remains a major public health threat in the poorest regions of the Americas. The DOTS strategy was implemented to control TB in the region in 1993, and the new Stop TB strategy, emphasizing high-quality DOTS expansion, in 2006. OBJECTIVES: To describe TB epidemiology in the region of the Americas from 1994 to 2005 and to analyze the progress made towards and prospects for achieving Goal 6 of the Millennium Development Goals (MDGs) by 2015. METHODS: TB incidence, mortality and prevalence rates as well as DOTS coverage and DOTS treatment success rates were collated from the World Health Organization (WHO) databases from 1994 to 2005. RESULTS: DOTS coverage and DOTS treatment success rates rose steadily from 1994 to 2005, with 88% of the population covered under DOTS by 2005, and an 80% success rate by the end of 2004. The TB incidence, prevalence and mortality rates have also decreased steadily from 1994 to date, but differ with respect to the various scenarios. CONCLUSIONS: With the exception of some countries, further reduction in TB incidence, prevalence and deaths by 2015 is possible. Widespread implementation of DOTS should continue in order to meet WHO targets and attain the MDGs.