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Tuberculosis profile: Brazil
Tuberculosis in Brazil: the impact of the COVID-19 pandemic
Fernandes Maia, C.M.; Barbosa Martelli, D. R.; Mendes L. da Silveira, D. M.; et al.
Sociedade Brasileira de Pneumologia e Tisiologia
(2022)
CC
J Bras Pneumol. 2022;48(2):e20220082
The spread of Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV-2) continues to progress, causing damage in several countries of the world due to its rapid transmissibility and significant mortality rates, despite government measures to contain its tra
...
nsmission, such as movement control, the closing of schools, bans on travel and public gatherings, the mandatory use
of masks, and hand hygiene. The coronavirus disease (COVID-19) has clinical manifestations that are similar to those found in other infections also transmitted through the airways, such as pulmonary tuberculosis (TB) Although TB is a global health problem, it is a curable disease, with affordable treatment and prevention. Nonetheless, it remains one of the leading
causes of death from a single infectious agent worldwide, a situation threatened by COVID-19.
more
Country Profile
Three classess of tests are now recommended in the latest consolidated guideles on tests for tuberculosis infection. It includes for the first-time a new class of Mycobacterium tuberculosis antigen-
...
based skin tests (TBSTs), and the two existing classes of tests: the tuberculin skin test (TST) and the interferon-gamma release assays (IGRAs).
IGRAs and TBSTs use Mycobacterium tuberculosis complex specific antigens and represent a significant advancement to TST which has been used for over half a century.
more
The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la
...
test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
more
Estimates of government spending and development assistance for tuberculosis exist, but less is known
about out-of-pocket and prepaid private spending. We aimed to provide comprehensive estimates of total spending on
...
tuberculosis in low-income and middle-income countries for 2000–17.
more
En la reunión de alto nivel de las Naciones Unidas del 2018 se fijó el objetivo de tratar al menos a 40 millones de personas con tuberculosis (TB) entre el 2018 y el 2022; sin embargo, en el 2021 ese objetivo solo se había cumplido en un 66%. Las
...
pruebas diagnósticas son fundamentales para lograr el objetivo, pero constituyen un eslabón débil en la continuidad de la atención. Las pruebas de diagnóstico rápido recomendadas por la Organización Mundial de la Salud (PDRO) son sumamente precisas, acortan el tiempo hasta el inicio del tratamiento, influyen en resultados importantes para el paciente y son costo-eficaces. Aunque el objetivo para el año 2025 es que todos los pacientes notificados se hagan inicialmente una PDRO, en el 2021 tan solo el 38% se hizo una PDRO como prueba inicial, y se determinó que el acceso a las pruebas diagnósticas era un problema crítico. Una de las principales consecuencias del uso insuficiente de las PDRO es la gran brecha en la detección de la farmacorresistencia. La presente Norma de la OMS: Acceso universal a las pruebas de diagnóstico rápido de la tuberculosis se basa en las directrices de la OMS y en el manual operativo conexo
more
Previous advocacy efforts have achieved tangible goals in terms garnering political commitments
to increase financing for TB—as seen at the 2018 UN High-Level Meeting on TB. The challenge
now is to ensure that these commitments are actually met within a global biomedical research
ecosystem that
...
is designed and incentivized to prioritize the health needs of wealthy populations
more
This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This is followed by key figures for the region, the rol
...
e of WHO in country support and, recognizing the importance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
more
This document provides practical guidance on planning and implementing next-generation sequencing (NGS) technology for characterization of Mycobacterium tuberculosis complex (MTBC) bacteria. The aim is to detect mutations associated with drug resist
...
ance in the context of a surveillance system for tuberculosis (TB).
more
Tuberculosis (TB) and particularly drug-resistant TB continue to represent major public health threats in the WHO European Region. This document details the Tuberculosis action plan for the WH
...
O European Region 2023–2030 as well as its monitoring and evaluation framework and outlines the vision and strategic actions for the TB response in the Region for this period. Developed through a Region-wide participatory consultation process, the TB action plan aims to support Member States to implement their national responses to the TB epidemic and provides strategies to enable the Region to reach the global End TB Strategy targets as well as aligning to the priorities of the European Programme of Work, 2020–2025 – “United Action for Better Health in Europe”.
more
The World Health Organization (WHO) Global Tuberculosis Report 2021 estimated that, in 2020, tuberculosis (TB) was the second most common infectious disease killer after coronavirus disease (COVID-1
...
9) and the 13th leading cause of death (1). Twenty-five per cent (25%) of the world’s population has latent TB infection, which can develop into disease. In 2020, WHO estimated that 9.9 million people fell ill with TB, but only about 5.8 million (60%) were diagnosed, reported and treated, an 18% fall from 7.1 million in 2019. WHO also estimates that, between 2019 and 2020, global TB mortality increased from 1.2 to 1.5 million, a 5.6% increase
more
The World Health Organization (WHO) Global Tuberculosis Report 2021 estimated that, in 2020, tuberculosis (TB) was the second most common infectious disease killer after coronavirus disease (COVID-1
...
9) and the 13th leading cause of death (1). Twenty-five per cent (25%) of the world’s population has latent TB infection, which can develop into disease. In 2020, WHO estimated that 9.9 million people fell ill with TB, but only about 5.8 million (60%) were diagnosed, reported and treated, an 18% fall from 7.1 million in 2019. WHO also estimates that, between 2019 and 2020, global TB mortality increased from 1.2 to 1.5 million, a 5.6% increase
more
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
...
3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more
Estimates of TB burden
Accessed 10 April 2015
