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Reversing the tuberculosis upwards trend: a success story in Romania

¹ National Institute "Marius Nasta", Bucharest, Romania, ² Swiss Lung Association, Bern, Switzerland, ³ Hygiene and Preventive Medicine Institute, University of Sassari, Sassari, ⁴ World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy, and ⁵ World Health Organization Regional Office for Europe, Copenhagen, Denmark.

CORRESPONDENCE: G. B. Migliori, WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, via Roncaccio 16, 21049, Tradate, Italy. Fax: 39 331829402. E-mail: giovannibattista.migliori{at}fsm.it

Keywords: Epidemiology, incidence, Romania, success rate, targets, tuberculosis

Received: July 9, 2008
Accepted September 8, 2008

At present, no published evidence is available on the effectiveness of the DOTS (directly observed treatment, short-course) strategy in reducing the incidence of tuberculosis (TB) within a country in the European "hot spots". The present study aimed to demonstrate the effectiveness of the strategy implementation in reversing the epidemiological TB trend in Romania based on programmatic data analysis.

Key programme indicators were analysed from 1998 to 2007, and included DOTS coverage, case-detection rate, treatment success and overall incidence of notified cases. Internationally agreed definitions were used.

The key programme indicators began declining and the World Health Assembly targets were reached (79% case-detection of new sputum-smear positive cases and 85.5% success rate in new culture-positive TB cases), 7 yrs after initiation of the DOTS expansion.

The success story in Romania suggests that other middle-income, high-incidence countries (i.e. those belonging to the former Soviet Union) might be able to reach the World Health Assembly Targets and curb the burden of tuberculosis.