Tuberculosis Elimination: Implications and Challenges

Rasha Aziz Salama; Nihal Amir Rizk

doi:10.55489/njcm.140920233127

Authors

Rasha Aziz Salama Ras Al Khaimah Medical and Health Science University, Ras Al Khaimah, UAE & Kasr El Aini School of Medicine Cairo University, Cairo, Egypt https://orcid.org/0000-0002-1102-9306
Nihal Amir Rizk Ras al Khaimah Medical and Health Science University, Ras Al khimah, UAE

DOI:

https://doi.org/10.55489/njcm.140920233127

Keywords:

Control, Challenges, Elimination, Tuberculosis

Abstract

Background: Tuberculosis elimination remains a significant global health challenge, despite the efforts made by governments and international organizations to control and eliminate the disease. The study objectives were to explore the global TB control efforts and highlight the possible challenges and implications in the way to TB elimination. Recommendations to add momentum to current health care efforts were also outlined.

Methods: Relevant works of literature were retrieved from different journals and web pages. The electronic databases were searched using the key.

Results: A review of the progress made over the past years in the control of TB has shown that the goal of TB elimination has not yet been achieved. The high burden of TB, limited access to TB diagnosis and treatment, drug-resistant TB, weak health systems particularly in low- and middle-income countries, socioeconomic factors, and lack of political commitment and resources are among the major challenges that have hindered the successful elimination of tuberculosis.

Conclusions: a sustained and coordinated effort from governments, private sector, international organizations, and other stakeholders, including increased funding, political commitment, and a focus on addressing the root causes of TB transmission and disease burden are required to address these challenges.

References

World Health Organization. Tuberculosis fact sheet 2023. Available at: https://www.who.int/news-room/fact-sheets/ detail/tuberculosis. Accessed Feb 20th 2023

World Health Organization. Global tuberculosis report 2022. Geneva. Available at: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022. Accessed Feb 3rd 2023.

Institute of Medicine (US) Committee on the Elimination of Tuberculosis in the United States; Geiter L, editor. Ending Ne-glect: The Elimination of Tuberculosis in the United States. Washington (DC): National Academies Press (US); 2000. 3, Tuberculosis Elimination and the Changing Role of Tubercu-losis Control. Programs. Available at: https://www.ncbi.nlm.nih. gov/books/NBK225599/. Ac-cessed March 13 th 2023.

Piot P. old and new challenges in infectious diseases. Internal journal of infectious diseases 2014;21(1):37. Accessed April 3rd 2023 Doi: https://doi.org/10.1016/j.ijid.2014.03.490

Lönnroth K, Migliori G, Abubakar I, D'Amboise L, de Vries G, Diel R, etal., Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J. 2015 Apr;45(4):928-52.

WHO Global Tuberculosis Programme‎. TB: a global emergen-cy, WHO report on the TB epidemic 1994. World Health Or-ganization. Available at: https://apps.who.int/iris/handle/ 10665/58749. Accessed March 23 2023

Uplekar M, Weil D, Lonnroth K, et al. WHO's new end TB strategy. Lancet 2015; 385: 1799-1801. Doi: https://doi.org/10.1016/S0140-6736(15)60570-0 PMid:25814376

World Health Organization. The global plan to stop tb 2006-2015: progress report 2006-2008.Geneva,2009. Available at: https://stoptb.org/assets/documents/global/plan/The_global_plan_progress_report1.pdf. Accessed Feb 20 2023.

Jürgens R, Csete J, Lim H, Timberlake S, Smith M. Human Rights and the Global Fund to Fight AIDS, Tuberculosis and Malaria: How Does a Large Funder of Basic Health Services Meet the Challenge of Rights-Based Programs? Health Hum Rights. 2017 Dec;19(2):183-195. PMID: 29302175; PMCID: PMC5739369.

Centis R, D'Ambrosio L,Zumla A, et al. Shifting from tubercu-losis control to elimination: Where are we? What are the var-iables and limitations? Is it achievable? Int J Infect Dis 2017; 56: 30-33. Doi: https://doi.org/10.1016/j.ijid.2016.11.416 PMid:27916675

Sakamoto, H., Lee, S., Ishizuka, A. et al. Challenges and oppor-tunities for eliminating tuberculosis - leveraging political momentum of the UN high-level meeting on tuberculosis. BMC Public Health 2019; 19, 76. Doi: https://doi.org/10.1186/s12889-019-6399-8 PMid:30651096 PMCid:PMC6335677

World Health Organization. Tuberculosis, 2018. Available at: https://www.who.int/news-room/questions-and-answers/ item/tuberculosis. Accessed Jan 20 2023.

Ndzi E, Nkenfou C, Pefura E, Mekue L, Guiedem E, Nguefeu C, Ngoufack M, Elong E, Yatchou L, Ndjolo A, Kuiate JR. Tubercu-losis diagnosis: algorithm that May discriminate latent from active tuberculosis. Heliyon. 2019;5(10): e02559. Doi: https://doi.org/10.1016/j.heliyon.2019.e02559 PMid:31692671 PMCid:PMC6806400

Lönnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemics: The role of risk factors and social determinants. Social Science and Medicine 2009; 68 :2240-2246. Doi: https://doi.org/10.1016/j.socscimed.2009.03.041 PMid:19394122

World Health Organization: Global TB progress at risk, 2020. Available at: https://www.who.int/news/item/14-10-2020-who-global-tb-progress-at-risk. Accessed Dec.4th 2023.

Togun, T., Kampmann, B., Stoker, N.G.& Lipman M. Anticipat-ing the impact of the COVID-19 pandemic on TB patients and TB control programmes. Ann Clin Microbiol Antimi-crob.2020; 19, 21. Doi: https://doi.org/10.1186/s12941-020-00363-1 PMid:32446305 PMCid:PMC7245173

Tuberculosis and HIV. Available at: https://www.unaids.org/ sites/default/files/media_asset/tb-and-hiv_en.pdf , Accessed on March15.2023

Restrepo BI. Diabetes and Tuberculosis. Microbiol Spectr. 2016 ;4(6): 10.1128/microbiolspec.TNMI7-0023-2016. Doi: https://doi.org/10.1128/microbiolspec.TNMI7-0023-2016 PMid:28084206 PMCid:PMC5240796

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N. etal. IDF Diabetes Atlas Committee. Global and regional di-abetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Fed-eration Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov. Doi: https://doi.org/10.1016/j.diabres.2019.107843 PMid:31518657

:107843. doi: 10.1016/j.diabres.2019.107843. Epub 2019 Sep 10. Doi: https://doi.org/10.1016/j.diabres.2019.107843 PMid:31518657

Aziz R, Nizar N , Mustafa M , Musab A , Fahd M and Musab A. Vaping: Is it Safer than Conventional Tobacco Smoking. Ann Med Health Sci Res.2021;11:159-175

K Park. Park's Textbook of Preventive and Social Medicine, 25th ed. Jabalpur: Bhanot Publishers; 2011. p 214.

Labib NA, Radwan GN, Salama RA, Hores NA. Evaluation of knowledge change of internal medicine residents following a training program in smoking cessation, Pak J Med Res 2012; 52(2).

Trauer JM, Kawai A, Coussens AK, Datta M, Williams BM, McBryde ES, Ragonnet R. Timing of Mycobacterium tubercu-losis exposure explains variation in BCG effectiveness: a sys-tematic review and meta-analysis. Thorax 2021;76:1131-1141. Doi: https://doi.org/10.1136/thoraxjnl-2020-216794 PMid:33893231 PMCid:PMC8526882

Kuan R, Muskat K, Peters B, Lindestam Arlehamn CS. Is map-ping the BCG vaccine-induced immune responses the key to improving the efficacy against tuberculosis? J Intern Med. 2020 Dec;288(6):651-660. Doi: https://doi.org/10.1111/joim.13191 PMid:33210407 PMCid:PMC9432460

World Health Organization. WHO 1982, Tech. Rep. Se r. No. 671

Kaufmann S. Fact and fiction in tuberculosis vaccine research: 10 years later. The lancet infectious diseases2011;11(8):579-650. Doi: https://doi.org/10.1016/S1473-3099(11)70146-3 PMid:21798463

WHO consolidated guidelines on drug-resistant tuberculosis treatment. Geneva: World Health Organization; 2019. Li-cence: CC BY-NC-SA 3.0 IGO

Jang J, Chung J. Diagnosis and treatment of multidrug-resistant tuberculosis. Yeungnam Univ J Med. 2020 Oct;37(4):277-285. Doi: https://doi.org/10.12701/yujm.2020.00626 PMid:32883054 PMCid:PMC7606956

Centers for Disease Control and Prevention. drug resistant TB. Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, ,2022. Available at: https://www.cdc.gov/tb/topic/drtb/default.htm

Tiberi S, Utjesanovic N, Galvin J, Centis R, Ambrosio L, Boom MV, Zumla A, Migliori GB. Drug resistant TB - latest devel-opments in epidemiology, diagnostics and management, In-ternational Journal of Infectious Diseases 2022, 124 (1): S20-S25 Doi: https://doi.org/10.1016/j.ijid.2022.03.026 PMid:35342000

Health desk. What causes multidrug-resistant tuberculosis (MDR-TB)?2022. Available at: https://health-desk.org/ arti-cles/what-causes-multidrug-resistant-tuberculosis-mdr-tb

Menzies N, Bellerose M, Testa C, Swartwood N, Malyuta Y, Cohen T, Marks S, Hill A, Date A, Maloney S, Bowden S, Grills A, Salomon J. Impact of Effective Global Tuberculosis Control on Health and Economic Outcomes in the United States. Am J Respir Crit Care Med. 2020 Dec 1;202(11):1567-1575. Doi: https://doi.org/10.1164/rccm.202003-0526OC PMid:32645277 PMCid:PMC7706168

Radwan, G.N., Loffredo, C.A., Aziz, R. et al. Implementation, barriers and challenges of smoke-free policies in hospitals in Egypt. BMC Res Notes,2012; 5, 568. Doi: https://doi.org/10.1186/1756-0500-5-568 PMid:23069011 PMCid:PMC3519804

Shashikantha S, Sheethal M. Awareness about tuberculosis in a rural area of Mandya district: A cross-sectional study in southern Karnataka. Journal of Family Medicine and Primary Care2022; 11(2): 587-592. Doi: https://doi.org/10.4103/jfmpc.jfmpc_1304_21 PMid:35360804 PMCid:PMC8963610

The Global Fund. Global Fund Strategy (2023-2028): Fighting Pandemics and Building a Healthier and More Equitable World. Geneva: The Global Fund, 2021.

Nsubuga, P., Nwanyanwu, O., Nkengasong, J.N. et al. Strength-ening public health surveillance and response using the health systems strengthening agenda in developing countries. BMC Public Health 2010,10 (Suppl 1), S5 (2010). Doi: https://doi.org/10.1186/1471-2458-10-S1-S5 PMid:21143827 PMCid:PMC3005577

World Health Organization. WHO operational handbook on tuberculosis. Module 3: Diagnosis - Rapid diagnostics for tu-berculosis detection 2021 update. Geneva: WHO, 2021.Cobelens F, Suri RK, Helinski M, Makanga M, Weinberg AL, Schaffmeister B, Deege F, Hatherill M; TB Vaccine Roadmap Stakeholder Group. Accelerating research and de-velopment of new vaccines against tuberculosis: a global roadmap. Lancet Infect Dis. 2022;22(4):e108-e120. Doi: https://doi.org/10.1016/S1473-3099(21)00810-0 PMid:35240041

Dartois, V.A., Rubin, E.J. Anti-tuberculosis treatment strate-gies and drug development: challenges and priorities. Nat Rev Microbiol 20, 685-701 (2022). Doi: https://doi.org/10.1038/s41579-022-00731-y PMid:35478222 PMCid:PMC9045034

Horton R, Samarasekera U. WHO's Director-General candi-dates: visions and priorities. Lancet. 2016 Oct 29; 388 (10056):2072-2095. Doi: https://doi.org/10.1016/S0140-6736(16)31847-5 PMid:27745880

Khim K, Andermann A. Challenges and opportunities in ad-dressing social determinants of child health in Cambodia: perspectives and experience of frontline providers in two health districts. Can J Public Health. 2021 Apr;112(2):317-330 Doi: https://doi.org/10.17269/s41997-020-00442-y PMid:33471345 PMCid:PMC7816155

MLA style: Robert Koch - Facts. NobelPrize.org. Nobel Prize Outreach AB 2023. Available at: https://www.nobelprize.org/ priz-es/medicine/1905/koch/facts/. Accessed on June 29th, 2023.