title: Tuberculosis deaths averted by implementation of the DOTS strategy in Kazakhstan.
abstract: METHODS
  Kazakhstan began implementing the DOTS strategy for tuberculosis (TB) in 1998.
  
  
  OBJECTIVE
  Data were analyzed 1) to determine if changes in TB mortality rate (MR) and case fatality rate (CFR) in Kazakhstan for 1998-2003 differed from those of Uzbekistan and four adjacent Russian Federation (RF) oblasts that had not yet implemented DOTS, and 2) to estimate the number of deaths averted in Kazakhstan as a result of DOTS.
  
  
  METHODS
  Observed MRs were calculated, and predicted MRs for Kazakhstan were approximated by linear regression based on average slope of MRs from 1998 through 2003 in adjacent non-DOTS-implementing territories. Deaths averted were calculated by comparing predicted MRs to actual MRs by converting rate differences to numbers of deaths.
  
  
  RESULTS
  TB MRs in Kazakhstan decreased markedly, but remained stable or increased in the neighboring territories. CFRs decreased markedly in Kazakhstan and marginally in Uzbekistan, and increased in the neighboring RF oblasts. From 1998 to 2004, DOTS appears to have helped avert approximately 17,800 deaths in Kazakhstan.
  
  
  CONCLUSIONS
  DOTS has contributed markedly to a decrease in TB mortality in Kazakhstan. In settings where mortality data are relatively complete, deaths averted can be another indicator of DOTS effectiveness.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: M
authors.initials: M
authors.lastname: Favorov
authors.forename: E
authors.initials: E
authors.lastname: Belilovsky
authors.forename: I
authors.initials: I
authors.lastname: Aitmagambetova
authors.forename: S
authors.initials: S
authors.lastname: Ismailov
authors.forename: M E
authors.initials: ME
authors.lastname: White
authors.forename: T
authors.initials: T
authors.lastname: Chorba
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023801:Directly Observed Therapy / Q000379:methods*; D006801:Humans; D007623:Kazakhstan / Q000453:epidemiology; D016014:Linear Models; D014376:Tuberculosis / Q000188:drug therapy* / Q000401:mortality
chemical_list: D000995:Antitubercular Agents