MMWR Morb Mortal Wkly Rep. 2002 Mar 22;51(11):229-32.
Every year, approximately 2 million persons in India develop tuberculosis (TB), accounting for one fourth of the world's new TB cases. Organized TB control activities have existed in India for 40 years; however, the quality of diagnosis and treatment of TB in the public and private sectors has been variable, and TB incidence and prevalence trends have not changed substantially over this time. In 1992, the Indian government established a Revised National Tuberculosis Control Programme (RNTCP) using the directly observed treatment, short-course (DOTS) strategy recommended by the World Health Organization (WHO) (3). The DOTS strategy consists of sustained government commitment, effective laboratory-based diagnosis, standard treatment given under direct observation, secure drug supply, and systematic monitoring and evaluation. RNTCP was implemented in pilot areas beginning in 1993; large-scale implementation of the program began in late 1998. This report summarizes the process, outcomes, and challenges of RNTCP in India. RNTCP has implemented DOTS rapidly and has yielded positive results in TB control; however, continued commitment from Indian government authorities and the international community is needed to sustain and expand this ongoing program.
印度每年约有200万人罹患结核病（TB），占全球新增结核病病例的四分之一。印度开展有组织的结核病防治活动已有40年；然而，公共和私营部门结核病的诊断和治疗质量参差不齐，在此期间结核病发病率和患病率趋势并未发生实质性变化。1992年，印度政府采用世界卫生组织（WHO）推荐的直接观察短程治疗（DOTS）策略，制定了修订后的国家结核病控制规划（RNTCP）（3）。DOTS策略包括政府持续承诺、基于实验室的有效诊断、在直接观察下给予标准治疗、可靠的药品供应以及系统的监测和评估。RNTCP于1993年在试点地区开始实施；该规划于1998年末开始大规模实施。本报告总结了印度RNTCP的实施过程、成果及挑战。RNTCP迅速推行了DOTS，并在结核病控制方面取得了积极成果；然而，印度政府当局和国际社会需要持续努力，以维持和扩大这一正在进行的规划。
