Tuberculosis

Authors: Barry R. Bloom, Rifat Atun, Ted Cohen, Christopher Dye, Hamish Fraser, Gabriela Gomez, Gwen Knight, Megan Murray, Edward Nardell, Eric Rubin, Anna Vassall, Grigory Volchenkov, Richard White, Douglas Wilson, Prashant Yadav, Joshua Salomon

Abstract:

Despite progress in controlling tuberculosis (TB), the decline in incidence has been disappointing, pointing to the need for new strategies and more effective tools. HIV/AIDS is one factor that challenges effective control of TB, especially in Southern African countries. Three key elements are needed to achieve effective TB control and to meet the Sustainable Development Goals: (1) early and accurate diagnosis and drug-sensitivity testing, (2) patient access to and completion of effective treatment, and (3) prevention of progression from latent infection to disease. Prevention requires vaccination and screening of individual at high risk as well as interventions such as air disinfection and the use of masks and respirators in hospitals and other congregate settings. Recommendations stress the need to strengthen health systems in high-burden countries by emphasizing community-based care over hospital care; to improve information systems to ensure patient adherence and manage medication supply chains; and to invest in research to develop the necessary interventions. Fundamentally, current global TB control strategies must undergo revision and receive significant research funding.

 

 

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