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.