title: A five year retrospective surveillance; monitoring and evaluation for the regional tuberculosis control programme in Mersin, Turkey, 2004-2008.
abstract: OBJECTIVE
  The aim of this study is to identify and evaluate problems in regional tuberculosis control studies, using an international tuberculosis indicator.
  
  
  METHODS
  In this retrospective cohort study, the records of a total of 1,776 patients diagnosed with tuberculosis, followed up and treated from 2004-2008 in Mersin were evaluated. Indicators recommended by the World Health Organization were used as assessment criteria. Descriptive statistics were used to summarize data. The Mantel-Haenszel test was used for calculation of the risk between urban/rural, and between male/ female which were in different age groups.
  
  
  RESULTS
  During the five year period, new case notification rates were reduced and tuberculosis risk shifted to advanced age groups in our region. Tuberculosis development risk increased two-fold among males (p < 0.001). One-fifth of the tuberculosis cases had been diagnosed without sputum smears. Sputum microscopy was not done at the end of the initial phase in one-fifth of patients. During the five-year follow-up period, tuberculosis treatment success rate increased from 83% to 91% and cure rate increased from 49% to 67%. The death rate, treatment failure rate, default rate, and transmission rate decreased, and the directly observed treatment implementation increased.
  
  
  CONCLUSIONS
  Improvements were seen in diagnosis and treatment indicators beginning from 2006; the year when the directly supervised treatment application started. However, use of sputum smear microscopy is inadequate for the diagnosis and treatment of tuberculosis. Tuberculosis control studies should be monitored and evaluated using a tuberculosis indicator.
authors.affiliation: Department of Public Health, Mersin University Faculty of Medicine, Mersin, Turkey. onerkurt@mersin.edu.tr
authors.forename: A Oner
authors.initials: AO
authors.lastname: Kurt
authors.forename: Tayyar
authors.initials: T
authors.lastname: Saşmaz
authors.forename: Resul
authors.initials: R
authors.lastname: Buğdayci
authors.forename: Seva
authors.initials: S
authors.lastname: Oner
authors.forename: Gülçin
authors.initials: G
authors.lastname: Yapici
authors.forename: Ozdemir
authors.initials: O
authors.lastname: Ozdemir
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents