RT Journal Article
SR Electronic
T1 Towards tuberculosis elimination: an action framework for low-incidence countries
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 928
OP 952
DO 10.1183/09031936.00214014
VO 45
IS 4
A1 Knut Lönnroth
A1 Giovanni Battista Migliori
A1 Ibrahim Abubakar
A1 Lia D'Ambrosio
A1 Gerard de Vries
A1 Roland Diel
A1 Paul Douglas
A1 Dennis Falzon
A1 Marc-Andre Gaudreau
A1 Delia Goletti
A1 Edilberto R. González Ochoa
A1 Philip LoBue
A1 Alberto Matteelli
A1 Howard Njoo
A1 Ivan Solovic
A1 Alistair Story
A1 Tamara Tayeb
A1 Marieke J. van der Werf
A1 Diana Weil
A1 Jean-Pierre Zellweger
A1 Mohamed Abdel Aziz
A1 Mohamed R.M. Al Lawati
A1 Stefano Aliberti
A1 Wouter Arrazola de Oñate
A1 Draurio Barreira
A1 Vineet Bhatia
A1 Francesco Blasi
A1 Amy Bloom
A1 Judith Bruchfeld
A1 Francesco Castelli
A1 Rosella Centis
A1 Daniel Chemtob
A1 Daniela M. Cirillo
A1 Alberto Colorado
A1 Andrei Dadu
A1 Ulf R. Dahle
A1 Laura De Paoli
A1 Hannah M. Dias
A1 Raquel Duarte
A1 Lanfranco Fattorini
A1 Mina Gaga
A1 Haileyesus Getahun
A1 Philippe Glaziou
A1 Lasha Goguadze
A1 Mirtha del Granado
A1 Walter Haas
A1 Asko Järvinen
A1 Geun-Yong Kwon
A1 Davide Mosca
A1 Payam Nahid
A1 Nobuyuki Nishikiori
A1 Isabel Noguer
A1 Joan O'Donnell
A1 Analita Pace-Asciak
A1 Maria G. Pompa
A1 Gilda G. Popescu
A1 Carlos Robalo Cordeiro
A1 Karin Rønning
A1 Morten Ruhwald
A1 Jean-Paul Sculier
A1 Aleksandar Simunović
A1 Alison Smith-Palmer
A1 Giovanni Sotgiu
A1 Giorgia Sulis
A1 Carlos A. Torres-Duque
A1 Kazunori Umeki
A1 Mukund Uplekar
A1 Catharina van Weezenbeek
A1 Tuula Vasankari
A1 Robert J. Vitillo
A1 Constantia Voniatis
A1 Maryse Wanlin
A1 Mario C. Raviglione
YR 2015
UL http://erj.ersjournals.com/content/45/4/928.abstract
AB 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.Action framework for countries with low tuberculosis incidence: a coherent approach for eliminating tuberculosis http://ow.ly/H03ZZ