Tuberculosis control in Bolivia, Chile, Colombia and Peru: why does incidence vary so much between neighbors?
METHODS
In 2003, Peru and Bolivia reported the highest annual tuberculosis (TB) incidence rates in the Americas. Neighboring Colombia and Chile had lower annual incidence rates despite their proximity.


OBJECTIVE
To determine what factors contribute to differences in TB incidence rates among Chile, Colombia, Bolivia and Peru.


METHODS
Multiple sources of literature dating between 1990 and 2005 were used and World Health Organization TB control guidelines were consulted for policy level comparisons.


RESULTS
Comprehensive implementation of the DOTS strategy is the main factor explaining the differences in TB incidence rates, even after considering socio-economic factors.


CONCLUSIONS
Cross-national comparisons suggest ways to improve regional DOTS implementation.
Sobero
R A
RA
University of California Los Angeles, School of Public Health, Department of Health Services, P.O. Box 951772, Los Angeles, CA 90095-1772, USA. rsobero@earthlink.net
Peabody
J W
JW
D001838:Bolivia / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D003105:Colombia / Q000453:epidemiology; D003140:Communicable Disease Control / Q000379:methods*; D006801:Humans; D015994:Incidence; D010568:Peru / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control*