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, 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; A Torres-Duque, Carlos; Umeki, Kazunori; Uplekar, Mukund; van Weezenbeek, Catharina; Vasankari, Tuula; Vitillo, Robert J; Voniatis, Constantia; Wanlin, Maryse; Raviglione, Mario C
Journal:
The 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, Knuten_GB
dc.contributor.authorMigliori, Giovanni Battistaen_GB
dc.contributor.authorAbubakar, Ibrahimen_GB
dc.contributor.authorD'Ambrosio, Liaen_GB
dc.contributor.authorde Vries, Gerarden_GB
dc.contributor.authorDiel, Rolanden_GB
dc.contributor.authorDouglas, Paulen_GB
dc.contributor.authorFalzon, Dennisen_GB
dc.contributor.authorGaudreau, Marc-Andreen_GB
dc.contributor.authorGoletti, Deliaen_GB
dc.contributor.authorGonzález Ochoa, Edilberto Ren_GB
dc.contributor.authorLoBue, Philipen_GB
dc.contributor.authorMatteelli, Albertoen_GB
dc.contributor.authorNjoo, Howarden_GB
dc.contributor.authorSolovic, Ivanen_GB
dc.contributor.authorStory, Alistairen_GB
dc.contributor.authorTayeb, Tamaraen_GB
dc.contributor.authorvan der Werf, Marieke Jen_GB
dc.contributor.authorWeil, Dianaen_GB
dc.contributor.authorZellweger, Jean-Pierreen_GB
dc.contributor.authorAbdel Aziz, Mohameden_GB
dc.contributor.authorAl Lawati, Mohamed R Men_GB
dc.contributor.authorAliberti, Stefanoen_GB
dc.contributor.authorArrazola de Oñate, Wouteren_GB
dc.contributor.authorBarreira, Draurioen_GB
dc.contributor.authorBhatia, Vineeten_GB
dc.contributor.authorBlasi, Francescoen_GB
dc.contributor.authorBloom, Amyen_GB
dc.contributor.authorBruchfeld, Judithen_GB
dc.contributor.authorCastelli, Francescoen_GB
dc.contributor.authorCentis, Rosellaen_GB
dc.contributor.authorChemtob, Danielen_GB
dc.contributor.authorCirillo, Daniela Men_GB
dc.contributor.authorColorado, Albertoen_GB
dc.contributor.authorDadu, Andreien_GB
dc.contributor.authorDahle, Ulf Ren_GB
dc.contributor.authorDe Paoli, Lauraen_GB
dc.contributor.authorDias, Hannah Men_GB
dc.contributor.authorDuarte, Raquelen_GB
dc.contributor.authorFattorini, Lanfrancoen_GB
dc.contributor.authorGaga, Minaen_GB
dc.contributor.authorGetahun, Haileyesusen_GB
dc.contributor.authorGlaziou, Philippeen_GB
dc.contributor.authorGoguadze, Lashaen_GB
dc.contributor.authorDel Granado, Mirthaen_GB
dc.contributor.authorHaas, Walteren_GB
dc.contributor.authorJärvinen, Askoen_GB
dc.contributor.authorKwon, Geun-Yongen_GB
dc.contributor.authorMosca, Davideen_GB
dc.contributor.authorNahid, Payamen_GB
dc.contributor.authorNishikiori, Nobuyukien_GB
dc.contributor.authorNoguer, Isabelen_GB
dc.contributor.authorO'Donnell, Joanen_GB
dc.contributor.authorPace-Asciak, Analitaen_GB
dc.contributor.authorPompa, Maria Gen_GB
dc.contributor.authorPopescu, Gilda Gen_GB
dc.contributor.authorRobalo Cordeiro, Carlosen_GB
dc.contributor.authorRønning, Karinen_GB
dc.contributor.authorRuhwald, Mortenen_GB
dc.contributor.authorSculier, Jean-Paulen_GB
dc.contributor.authorSimunović, Aleksandaren_GB
dc.contributor.authorSmith-Palmer, Alisonen_GB
dc.contributor.authorSotgiu, Giovannien_GB
dc.contributor.authorSulis, Giorgiaen_GB
dc.contributor.authorA Torres-Duque, Carlosen_GB
dc.contributor.authorUmeki, Kazunorien_GB
dc.contributor.authorUplekar, Mukunden_GB
dc.contributor.authorvan Weezenbeek, Catharinaen_GB
dc.contributor.authorVasankari, Tuulaen_GB
dc.contributor.authorVitillo, Robert Jen_GB
dc.contributor.authorVoniatis, Constantiaen_GB
dc.contributor.authorWanlin, Maryseen_GB
dc.contributor.authorRaviglione, Mario 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.journalThe European Respiratory Journalen_GB

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