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    Jan 16, 2021
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    Towards tuberculosis elimination: an action framework for low-incidence countries

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    Lonnroth et al - 2015 - Towards ...
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    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
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    Issue Date
    2015-03-18
    
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    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
    URI
    http://hdl.handle.net/10144/550559
    DOI
    10.1183/09031936.00214014
    PubMed ID
    25792630
    Language
    en
    ISSN
    1399-3003
    ae974a485f413a2113503eed53cd6c53
    10.1183/09031936.00214014
    Scopus Count
    Collections
    TB

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