[Results of tuberculosis control programs in Madagascar from 1996 to 2004]. / Etat des lieux de la lutte contre la tuberculose à Madagascar de 1996 à 2004.

OBJECTIVE: Madagascar's national tuberculosis control program has been operational since 1991. The purpose of this article is to provide up-to-date information about the results of this program. METHOD: Data from reports sent to the Tuberculosis Control Department between 1996 and 2004 by diagnosis and treatment centers were retrospectively studied. Special focus was placed on new cases of tuberculosis identified by positive smear. RESULTS: During the study period the annual incidence of new cases of tuberculosis confirmed by positive smear increased from 65 to 82 per 100,000 inhabitants. The highest incidence of new cases was observed in the active population. The treatment success rate rose from 64.4% to 70.8% in patients with positive smear tests. The dropout rate decreased from 21% to 16.5%. However discrepancies were observed between the number of cases diagnosed and number of cases treated. CONCLUSIONS: These findings indicate that tuberculosis control improved slowly over the study period. However these data do not allow identification of strategies to improve program performance. This will require detailed review of data taking into account the context in which they were obtained.

Etat des lieux de la lutte contre la tuberculose a Madagascar de 1996 a 2004

Objectif. Le programme de lutte contre la tuberculose a Madagascar est fonctionnel depuis 1991; et la presente etude consiste a decrire l'evolution des resultats de cette lutte. Methodologie. Il s'agit d'une etude retrospective des rapports envoyes par les centres de diagnostic et de traitement au service de lutte contre la tuberculose a Madagascar; entre 1996 et 2004. L'etude a ete focalisee sur les nouveaux cas de tuberculose a frottis positif. Resultats. Durant la periode etudiee; l'incidence annuelle des cas a frottis positifs a augmente de 65 a 82 pour 100 000 habitants. La maladie affecte beaucoup plus la population active. Le taux de reussite du traitement est passe de 64;4a 70;8chez les cas a frottis positifs. Le taux d'abandon a diminue de 21a 16;5. Une discordance de donnees entre le nombre de cas depistes et le nombre de cas traites est observee. Conclusion. Une amelioration lente des resultats de la lutte contre la tuberculose est observee. Ces resultats ne permettent pas neanmoins d'identifier les strategies pour ameliorer encore les performances du programme. Une analyse plus detaillee des donnees en fonction des contextes serait necessaire