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

Hdl Handle:
http://hdl.handle.net/10144/550559
Title:
Towards tuberculosis elimination: an action framework for low-incidence countries
Authors:
Lönnroth, K; Migliori, G B; Abubakar, I; D'Ambrosio, L; de Vries, G; Diel, R; Douglas, P; Falzon, D; Gaudreau, M-A; Goletti, D; González Ochoa, E R; LoBue, P; Matteelli, A; Njoo, H; Solovic, I; Story, A; Tayeb, T; van der Werf, M J; Weil, D; Zellweger, J-P; Abdel Aziz, M; Al Lawati, M R M; Aliberti, S; Arrazola de Oñate, W; Barreira, D; Bhatia, V; Blasi, F; Bloom, A; Bruchfeld, J; Castelli, F; Centis, R; Chemtob, D; Cirillo, D M; Colorado, A; Dadu, A; Dahle, U R; De Paoli, L; Dias, H M; Duarte, R; Fattorini, L; Gaga, M; Getahun, H; Glaziou, P; Goguadze, L; Del Granado, M; Haas, W; Järvinen, A; Kwon, G-Y; Mosca, D; Nahid, P; Nishikiori, N; Noguer, I; O'Donnell, J; Pace-Asciak, A; Pompa, M G; Popescu, G G; Robalo Cordeiro, C; Rønning, K; Ruhwald, M; Sculier, J-P; Simunović, A; Smith-Palmer, A; Sotgiu, G; Sulis, G; A Torres-Duque, C; Umeki, K; Uplekar, M; van Weezenbeek, C; Vasankari, T; Vitillo, R J; Voniatis, C; Wanlin, M; Raviglione, M C
Journal:
European Respiratory Journal
Abstract:
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.
Publisher:
European Respiratory Society
Issue Date:
18-Mar-2015
URI:
http://hdl.handle.net/10144/550559
DOI:
10.1183/09031936.00214014
PubMed ID:
25792630
Language:
en
ISSN:
1399-3003
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorLönnroth, Ken_GB
dc.contributor.authorMigliori, G Ben_GB
dc.contributor.authorAbubakar, Ien_GB
dc.contributor.authorD'Ambrosio, Len_GB
dc.contributor.authorde Vries, Gen_GB
dc.contributor.authorDiel, Ren_GB
dc.contributor.authorDouglas, Pen_GB
dc.contributor.authorFalzon, Den_GB
dc.contributor.authorGaudreau, M-Aen_GB
dc.contributor.authorGoletti, Den_GB
dc.contributor.authorGonzález Ochoa, E Ren_GB
dc.contributor.authorLoBue, Pen_GB
dc.contributor.authorMatteelli, Aen_GB
dc.contributor.authorNjoo, Hen_GB
dc.contributor.authorSolovic, Ien_GB
dc.contributor.authorStory, Aen_GB
dc.contributor.authorTayeb, Ten_GB
dc.contributor.authorvan der Werf, M Jen_GB
dc.contributor.authorWeil, Den_GB
dc.contributor.authorZellweger, J-Pen_GB
dc.contributor.authorAbdel Aziz, Men_GB
dc.contributor.authorAl Lawati, M R Men_GB
dc.contributor.authorAliberti, Sen_GB
dc.contributor.authorArrazola de Oñate, Wen_GB
dc.contributor.authorBarreira, Den_GB
dc.contributor.authorBhatia, Ven_GB
dc.contributor.authorBlasi, Fen_GB
dc.contributor.authorBloom, Aen_GB
dc.contributor.authorBruchfeld, Jen_GB
dc.contributor.authorCastelli, Fen_GB
dc.contributor.authorCentis, Ren_GB
dc.contributor.authorChemtob, Den_GB
dc.contributor.authorCirillo, D Men_GB
dc.contributor.authorColorado, Aen_GB
dc.contributor.authorDadu, Aen_GB
dc.contributor.authorDahle, U Ren_GB
dc.contributor.authorDe Paoli, Len_GB
dc.contributor.authorDias, H Men_GB
dc.contributor.authorDuarte, Ren_GB
dc.contributor.authorFattorini, Len_GB
dc.contributor.authorGaga, Men_GB
dc.contributor.authorGetahun, Hen_GB
dc.contributor.authorGlaziou, Pen_GB
dc.contributor.authorGoguadze, Len_GB
dc.contributor.authorDel Granado, Men_GB
dc.contributor.authorHaas, Wen_GB
dc.contributor.authorJärvinen, Aen_GB
dc.contributor.authorKwon, G-Yen_GB
dc.contributor.authorMosca, Den_GB
dc.contributor.authorNahid, Pen_GB
dc.contributor.authorNishikiori, Nen_GB
dc.contributor.authorNoguer, Ien_GB
dc.contributor.authorO'Donnell, Jen_GB
dc.contributor.authorPace-Asciak, Aen_GB
dc.contributor.authorPompa, M Gen_GB
dc.contributor.authorPopescu, G Gen_GB
dc.contributor.authorRobalo Cordeiro, Cen_GB
dc.contributor.authorRønning, Ken_GB
dc.contributor.authorRuhwald, Men_GB
dc.contributor.authorSculier, J-Pen_GB
dc.contributor.authorSimunović, Aen_GB
dc.contributor.authorSmith-Palmer, Aen_GB
dc.contributor.authorSotgiu, Gen_GB
dc.contributor.authorSulis, Gen_GB
dc.contributor.authorA Torres-Duque, Cen_GB
dc.contributor.authorUmeki, Ken_GB
dc.contributor.authorUplekar, Men_GB
dc.contributor.authorvan Weezenbeek, Cen_GB
dc.contributor.authorVasankari, Ten_GB
dc.contributor.authorVitillo, R Jen_GB
dc.contributor.authorVoniatis, Cen_GB
dc.contributor.authorWanlin, Men_GB
dc.contributor.authorRaviglione, M Cen_GB
dc.date.accessioned2015-04-23T23:01:30Z-
dc.date.available2015-04-23T23:01:30Z-
dc.date.issued2015-03-18-
dc.identifier.citationTowards tuberculosis elimination: an action framework for low-incidence countries. 2015: Eur. Respir. J.en_GB
dc.identifier.issn1399-3003-
dc.identifier.pmid25792630-
dc.identifier.doi10.1183/09031936.00214014-
dc.identifier.urihttp://hdl.handle.net/10144/550559-
dc.description.abstractThis 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.en_GB
dc.languageENG-
dc.language.isoenen
dc.publisherEuropean Respiratory Societyen_GB
dc.rightsArchived with thanks to The European Respiratory Journal's Open Accessen_GB
dc.titleTowards tuberculosis elimination: an action framework for low-incidence countriesen
dc.identifier.journalEuropean Respiratory Journalen_GB

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