Stop TB Communicable Diseases
The new WHO recommendations for the treatment of isoniazid-resistant, rifampicin-susceptible TB are based upon a review of evidence from patients treated with such regimens by a Guideline Development Group in conformity with WHO requirements for evidence-based policies.
This is an update of a seven-year TB and Leprosy national strategic plan (TBL-NSP), which extends from 2013 to 2020. The update focuses on the plan covering from 2017-20 and is based on the 2017 external mid-term programme review key findings and recommendations; the global and national End TB strat
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e-gies and targets; stakeholders consultation and recent revision of the national TB guidelines.
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The mandate of the National Tuberculosis Control Programme is to provide leadership and stewardship to accelerate intense and coordinated efforts to reduce the adult TB burden of 290 per 100,000 population recently established in the 2013 National TB Prevalence Survey. Other key challenges are low T
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B case notification, unacceptably high TB death rates, low antiretroviral therapy (ART) coverage among TB/HIV patients and low drug-resistant notification and treatment.
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Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los
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años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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The SPPCHS project worked with the Ministry of Home Affairs to design a peer education program for prisons to provide knowledge, skills, and tools to prevent and respond to tuberculosis (TB) and HIV in prisons. AIDSFree held two training of trainers (TOT) in Dodoma to train 55 prison officers from 2
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6 prison facilities to train prison staff and inmates on the new peer education program.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t
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o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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The SAARC Member States have more than an estimated 2.0 million TB cases accounting for close to one-third of the total cases of TB in the world. India alone had almost one-fifth of the global disease burden due to TB. India, Pakistan and Bangladesh followed by Afghanistan are the major contributors
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of disease burden of TB in the SAARC Region. They are countries that have a dubious distinction of being on the list of 22 TB High Disease Countries in the world.
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The guide is suitable and can be used for the following audiences:
1. nurses and other trained healthcare workers who can use this manual as a self-study tool and then incorporate its guidance into their practice;
2. governmental and non-governmental employers of lay and professional TB treatment
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adherence workers, who can provide training and guidance to their staff using the guidance in this manual;
3. TB clinicians, programme managers, policy makers and other leaders, to make them aware of the full range of interventions required by a person on TB treatment to complete his or her treatment and thus understand the gap that often exists in the support provided to patients;
4. people who, with enhanced capacity and support, can act as peer counsellors and supporters for people affected by TB. This can include family members who, in most contexts, play an important role in offering support to people with TB.
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The guidelines acknowledge that overcrowding, unhygienic conditions and high inmate turn over contribute to the spread of infectious diseases within correctional facilities. The document states that voluntary HIV counselling and testing must be offered to all inmates when they enter facilities, duri
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ng their incarceration at an inmate’s request and upon their release. All inmates must be screened for TB symptoms upon entry to facilities and at least bi-annually thereafter as well as upon release. Universal screening for anal, oral and genital STIs must be done at entry and upon self-presentation
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou
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gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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PLoS ONE 12(7): e0180996. https://doi.org/10.1371/journal.pone.0180996
J Epidemiol Infect Dis 1(1): 00003.n DOI: 10.15406/jeid.2017.01.00003
Published: September 14, 2017
Research Article
Received: August 21, 2017; Accepted: August 29, 2017; Published: Spetember 05,
2017
This article is available in: http://www.imedpub.com/advanced-techniques-in-clinical-microbiology/