SETTING:

In 2003, Peru and Bolivia reported the highest annual tuberculosis (TB) incidence rates in the Americas. Neighboring Colombia and Chile had lower annual incidence rates despite their proximity.

OBJECTIVE:

To determine what factors contribute to differences in TB incidence rates among Chile, Colombia, Bolivia and Peru.

DESIGN:

Multiple sources of literature dating between 1990 and 2005 were used and World Health Organization TB control guidelines were consulted for policy level comparisons.

RESULTS:

Comprehensive implementation of the DOTS strategy is the main factor explaining the differences in TB incidence rates, even after considering socio-economic factors.

CONCLUSION:

Cross-national comparisons suggest ways to improve regional DOTS implementation.