González E, Armas L, Llanes M J
Surveillance and Research Group on TB, Leprosy and ARI, Pedro Kourí Institute of Tropical Medicine, La Lisa, Marianao 13, Havana City, Cuba.
Int J Tuberc Lung Dis. 2007 Apr;11(4):405-11.
The Cuban National Tuberculosis Control Programme (NTCP) was implemented in 1962, and has included directly observed treatment since 1971 and DOTS since 1982.
To assess the short-term trends of major indicators of tuberculosis (TB) elimination.
A surveillance system has been created on treatment and case finding. Data from the National TB Registry of the Ministry of Public Health were reviewed.
The incidence of TB declined from 1965 to 1991 from 65.0 to 4.7 per 100000 population, then reversed in the period 1992-1994. The implementation of a re-intervention package recovered the increase from 1995 to 1998. From 1999 to 2003, 97.5% of TB suspects identified underwent sputum smear microscopy. The incidence rate declined from 10.0 to 7.2/100000. In 2003 the case detection rate was 92.2%; the overall TB cure rate was 92% and TB human immunodeficiency virus (HIV) co-infection was 3%. Two of Cuba's 15 provinces reached incidence rates of <5/100000, eliminating TB as a public health problem.
Low incidence, high detection and cure rates, along with low rates of TB-HIV co-infection, are evidence of progress towards the elimination of TB as a public health problem in Cuba, using DOTS in a context of good socio-cultural and technological interaction.
古巴国家结核病控制规划（NTCP）于1962年实施，自1971年起采用直接观察治疗，自1982年起采用直接督导下的短程化疗（DOTS）。
评估结核病消除主要指标的短期趋势。
建立了治疗和病例发现监测系统。对公共卫生部国家结核病登记处的数据进行了审查。
结核病发病率从1965年至1991年从每10万人口65.0例降至4.7例，然后在1992 - 1994年期间出现逆转。实施一套重新干预措施使1995年至1998年的上升趋势得到扭转。1999年至2003年，97.5%被识别的结核病疑似患者接受了痰涂片显微镜检查。发病率从10.0/10万降至7.2/10万。2003年病例发现率为92.2%；总体结核病治愈率为92%，结核病与人类免疫缺陷病毒（HIV）合并感染率为3%。古巴15个省中有两个省的发病率降至<5/10万，消除了结核病作为公共卫生问题的状况。
低发病率、高发现率和治愈率以及低结核病 - HIV合并感染率，证明古巴在良好的社会文化和技术互动背景下采用DOTS在消除结核病作为公共卫生问题方面取得了进展。
