Towards tuberculosis elimination: an action framework for low-incidence countries

Details

• Alternative Title:
  Eur Respir J
• Personal Author:
  Lönnroth, Knut ; Migliori, Giovanni Battista ; Abubakar, Ibrahim ; D'Ambrosio, Lia ; de Vries, Gerard ; Diel, Roland ; Douglas, Paul ; Falzon, Dennis ; Gaudreau, Marc-Andre ; Goletti, Delia ; González Ochoa, Edilberto R. ; LoBue, Philip ; Matteelli, Alberto ; Njoo, Howard ; Solovic, Ivan ; Story, Alistair ; Tayeb, Tamara ; van der Werf, Marieke J. ; Weil, Diana ; Zellweger, Jean-Pierre ; Abdel Aziz, Mohamed ; Al Lawati, Mohamed R.M. ; Aliberti, Stefano ; Arrazola de Oñate, Wouter ; Barreira, Draurio ; Bhatia, Vineet ; Blasi, Francesco ; Bloom, Amy ; Bruchfeld, Judith ; Castelli, Francesco ; Centis, Rosella ; Chemtob, Daniel ; Cirillo, Daniela M. ; Colorado, Alberto ; Dadu, Andrei ; Dahle, Ulf R. ; De Paoli, Laura ; Dias, Hannah M. ; Duarte, Raquel ; Fattorini, Lanfranco ; Gaga, Mina ; Getahun, Haileyesus ; Glaziou, Philippe ; Goguadze, Lasha ; del Granado, Mirtha ; Haas, Walter ; Järvinen, Asko ; Kwon, Geun-Yong ; Mosca, Davide ; Nahid, Payam ; Nishikiori, Nobuyuki ; Noguer, Isabel ; O'Donnell, Joan ; Pace-Asciak, Analita ; Pompa, Maria G. ; Popescu, Gilda G. ; Robalo Cordeiro, Carlos ; Rønning, Karin ; Ruhwald, Morten ; Sculier, Jean-Paul ; Simunović, Aleksandar ; Smith-Palmer, Alison ; Sotgiu, Giovanni ; Sulis, Giorgia ; Torres-Duque, Carlos A. ; Umeki, Kazunori ; Uplekar, Mukund ; van Weezenbeek, Catharina ; Vasankari, Tuula ; Vitillo, Robert J. ; Voniatis, Constantia ; Wanlin, Maryse ; Raviglione, Mario C.
• Description:
  This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.
• Subjects:
  4 Perspective
• Source:
  Eur Respir J. 2015; 45(4):928-952.
• Document Type:
  Journal Article
• Volume:
  45
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e8eef943ec010a06a05d56dc9f564e9ddd0dbcb36920050f47bb0c71aca04cb5
• Download URL:
  https://stacks.cdc.gov/view/cdc/29570/cdc_29570_DS1.pdf
• File Type:
  [PDF - 1.44 MB ]