Did FIDELIS projects contribute to the detection of new smear-positive pulmonary tuberculosis cases in China?

Setting: The first phase of the Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB ( FIDELIS) projects in China started in 2003. Objective: To determine whether the FIDELISprojects contributed to the increased case detection rate for new smear-positive pulmonary tuberculosis (PTB) in China. Methods: We compared the case notification rates (CNRs) in the intervention year with those of the previous year in the FIDELISareas, then compared the difference between the CNRs of the intervention year and the previous year in the FIDELISareas with those in the non-FI-DELIS areas within the province. Results: There was an increase in the CNR in the intervention year compared with the previous year for all the project sites. The differences between the CNR in the intervention year and the previous year ranged from 6.4 to 31.1 per 100 000 population in the FIDELISareas and from 2.9 to 20.4/100 000 in the non- FIDELISareas. Differences-in-differences analysis shows that the differences in the CNRs in the FIDELISareas were not statistically significantly different from those in the non- FIDELISareas (P = 0.393). Conclusion: The FIDELISprojects may have contributed to the increase in case detection of new smear-positive PTB in China, but the level of evidence is low.