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Science 26 July 1996:
Vol. 273. no. 5274, pp. 497 - 500
DOI: 10.1126/science.273.5274.497
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Reports

Control Strategies for Tuberculosis Epidemics: New Models for Old Problems

S. M. Blower, * P. M. Small, P. C. Hopewell

Tuberculosis, although preventable and curable, causes more adult deaths than any other infectious disease. A theoretical framework for designing effective control strategies is developed and used to determine treatment levels for eradication, to assess the effects of noneradicating control, and to examine the global goals of the World Health Organization. The theory is extended to assess how suboptimal control programs contribute to the evolution of drug resistance. A new evaluation criterion is defined and used to suggest how control strategies can be improved. In order to control tuberculosis, treatment failure rates must be lower in developing countries than in developed countries.

S. M. Blower, Department of Epidemiology and Biostatistics and Department of Medicine, University of California, San Francisco, Box 1347, San Francisco General Hospital, San Francisco, CA 94143-1347, USA.
P. M. Small, Department of Medicine, Stanford Medical School, Stanford, CA 94305, USA.
P. C. Hopewell, Department of Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94143-1347, USA.
*   To whom correspondence should be addressed. E-mail: sally{at}cygnus.ucsf.edu


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