Three-fold reduction in the prevalence of tuberculosis over 25 years in Indonesia.
BACKGROUND
Tuberculosis (TB) remains the principal cause of death from a curable infectious disease. Indonesia is estimated to have the third highest case load worldwide, but TB prevalence has not been measured for 25 years.


METHODS
In 2004, 20000 households were selected in all 30 provinces. All adults (aged >/=15 years) in every household were screened for symptoms of pulmonary tuberculosis (PTB). Among those with symptoms, TB was diagnosed by sputum smear microscopy and sputum culture.


RESULTS
Eighty adults were positive on at least two sputum smears (104 per 100000 population, 95%CI 66-142). Prevalence was lower in Central Indonesia (Java-Bali, 59/100000) than in the Western (Sumatra, 160/100000) or Eastern regions (189/100000), but the estimated 225000 prevalent cases were distributed evenly among the three regions. The national per capita prevalence in 2004 was lower than in 1979-1982 by a factor of three (3.1, 95%CI 1.2-4.9), and the total number of cases was lower by a factor of two.


CONCLUSIONS
Although the 2004 national survey may have underestimated the prevalence of smear-positive TB in Indonesia, there is strong evidence that it fell markedly between 1979-1982 and 2004.
Soemantri
S
S
National Institute of Health Research and Development, Ministry of Health, Jalan Percetakan Negara 23A, Jakarta 10560, Indonesia. harsono@litbang.depkes.go.id
Senewe
F P
FP
Tjandrarini
D H
DH
Day
R
R
Basri
C
C
Manissero
D
D
Mehta
F
F
Dye
C
C
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006306:Health Surveys; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012293:Rifampin / Q000627:therapeutic use; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents; D012293:Rifampin